Endoscopic surgical clip applier

ABSTRACT

A ratchet assembly for use with an apparatus for applying surgical clips to body tissue includes a pawl and a biasing element. The pawl is slidably supported within a handle portion of the apparatus. The biasing element is supported by the handle portion and is in mechanical communication with the pawl. The biasing element has a biasing force configured to bias the pawl towards the rack such that the rack is permitted to translate in a distal direction, but is selectively inhibited from translating in a proximal direction until the rack is in a distal-most position. When the rack is urged in a proximal direction, the pawl exerts a force on the biasing element. When the force exerted on the biasing element is greater than the biasing force, the biasing element deflects allowing the pawl to disengage from the rack and permit the rack to translate in a proximal direction.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of and priority to U.S. ProvisionalPatent Application No. 62/415,585 filed Nov. 1, 2016, the entiredisclosure of which is incorporated by reference herein.

BACKGROUND Technical Field

The present disclosure relates to a surgical clip applier. Moreparticularly, the present disclosure relates to a surgical clip applierhaving a mechanism for stabilizing a jaw structure of the surgical clipapplier and also having a mechanism to prevent firing the surgical clipapplier when the surgical clip applier has exhausted the amount ofstored clips to prevent a dry firing of the surgical clip applier.

Background of Related Art

Laparoscopic procedures are performed in the interior of the abdomen.The procedures are through a small incision and through a narrowendoscopic tube or cannula inserted through a small entrance incision inthe skin. Minimally invasive procedures performed elsewhere in the bodyare often generally referred to as “endoscopic” procedures. The surgeonwill insert and extend a tube or cannula device in the body through theentrance incision to provide an access port. This port allows insertionof various surgical instruments therethrough.

These instruments such as the instant clip applier are used forperforming surgical procedures on organs, blood vessels, ducts, or bodytissue far removed from the incision. Often during these procedures, itis necessary to apply hemostatic clips to blood vessels or various ductsto prevent the flow of body fluids therethrough during the procedure.Many different hemostatic clips having different geometries may be usedand all are within the scope of the present disclosure.

One advantage of minimally invasive surgical procedures is the reductionof trauma to the patient as a result of accessing internal organsthrough smaller incisions. Known endoscopic clip appliers have greatlyfacilitated the advent of more advanced minimally invasive procedures bypermitting a number of clip applications during a single entry into thebody cavity. Commercially available endoscopic clip appliers aregenerally of 10 mm outer diameter and are adapted to be introducedthrough a 10 mm cannula. Other commercially available endoscopic clipappliers may also be generally of 5 mm outer diameter and are adapted tobe introduced through a 5 mm cannula.

As minimally invasive procedures continue to evolve and the advantagesthereof are extended to additional clinical applications, it has becomedesirable to further reduce incision size(s) and therefore the size ofall instrumentation introduced therethrough.

The structure of surgical instruments intended to perform numerousfunctions within a confined space is necessarily complex. The assemblyprocess for these instruments is often complicated and may involvenumerous relatively small parts to perform the numerous functions withrepeatability. It is therefore desirable to maximize the ease with whichsuch instruments may be assembled. It is also desirable to provide anendoscopic clip applier having a structure that minimizes torque on thejaws and to facilitate the easy application of surgical homeostaticclips while further minimizing the required incision size at thesurgical site. It is also desirable to provide an endoscopic clipapplier having a structure that prevents the surgeon from firing theclip applier (and locks the handle) when there are no more remaininghemostatic clips in the clip applier. It is also further desirable toprovide an endoscopic clip applier having a structure that provides thesurgeon with multiple redundant signals that the clip applier has firedand applied the clip.

SUMMARY

The present disclosure relates to reposable endoscopic surgical clipappliers.

According to an aspect of the present disclosure, an apparatus forapplying surgical clips to body tissue is provided and includes atrigger and a handle portion. The trigger is rotatably coupled to thehandle portion and the handle portion includes a rack, a pawl, and abiasing element. The rack is slidably supported within the handleportion, is in mechanical communication with the trigger, and isconfigured to translate from a first, proximal position, to a second,distal position. The pawl is slidably and rotatably supported within thehandle portion and is in selective engagement with the rack. The biasingelement is supported by the handle portion and is in mechanicalcommunication with the pawl. The biasing element has a biasing forceconfigured to bias the pawl towards the rack such that the rack ispermitted to translate in a distal direction, but is selectivelyinhibited from translating in a proximal direction until the rack is inthe second, distal position. Actuation of the trigger in a proximaldirection causes the rack to translate in a distal direction andactuation of the trigger in a distal direction urges the rack in aproximal direction and causes the pawl to exert a force on the biasingelement. When the force exerted on the biasing element is greater thanthe biasing force, the biasing element deflects allowing the pawl todisengage from the rack and permit the rack to translate in a proximaldirection to the first, proximal position.

In aspects, the rack may define a plurality of ratchet teeth on asurface thereof.

In some aspects, the pawl may define a tooth configured to selectivelyengage the plurality of ratchet teeth.

In certain aspects, the pawl may define a slot therethrough extending ina direction from the tooth towards a surface defined opposite the tooth.

In other aspects, the biasing element may bias the pawl toward the racksuch that the tooth engages the plurality of ratchet teeth of theratchet to selectively inhibit proximal translation of the rack.

In aspects, the pawl may be slidably and rotatably supported on a shaftdisposed on the handle portion.

In certain aspects, the apparatus may further include a second biasingelement that disposed within the slot of the pawl and that is interposedbetween the shaft of the handle portion and a portion of the slot of thepawl. The second biasing element is configured to exert additionalbiasing force on the pawl towards the rack.

In some aspects, the handle portion may define a slot therein configuredto slidably receive a shaft therein. The pawl is rotatably supported onthe shaft.

In other aspects, the apparatus may include a second biasing elementthat is disposed within the slot of the handle portion, the secondbiasing element interposed between the shaft and a portion of the slotto exert an additional biasing force on the shaft towards the rack suchthat the tooth of the pawl selectively engages the plurality of ratchetteeth of the ratchet to selectively inhibit proximal translation of therack.

In aspects, actuation of the trigger in a distal direction may urge therack in a proximal direction and cause the pawl to exert a force that isgreater than the biasing forces of the first and second biasing elementsand causes the pawl to translate in a direction away from the rack.Continued actuation of the trigger in the distal direction causes thepawl to change its engagement with the rack and permits the rack totranslate in a proximal direction to the first, proximal position.

According to another aspect of the present disclosure a ratchet assemblyfor use with an apparatus for applying surgical clips to body tissue isprovided and includes a pawl and a biasing element. The pawl is slidablysupported within a handle portion of the apparatus for applying surgicalclips to body tissue. The biasing element is supported by the handleportion of the apparatus and is in mechanical communication with thepawl. The biasing element has a biasing force configured to bias thepawl towards the rack such that the rack is permitted to translate in adistal direction but is selectively inhibited from translating in aproximal direction until the rack is in a distal-most position. When therack is urged in a proximal direction the pawl exerts a force on thebiasing element and when the force exerted on the biasing element isgreater than the biasing force, the biasing element deflects allowingthe pawl to disengage from the rack and permit the rack to translate ina proximal direction.

In aspects, the rack may define a plurality of ratchet teeth on asurface thereof.

In certain aspects, the pawl may define a tooth configured toselectively engage the plurality of ratchet teeth.

In some aspects, the pawl may define a slot therethrough extending in adirection from the tooth towards a surface defined opposite the tooth.

In aspects, the biasing element may bias the pawl toward the rack suchthat the tooth engages the plurality of ratchet teeth of the ratchet toselectively inhibit proximal translation of the rack.

In some aspects, the pawl may be slidably and rotatably supported on ashaft disposed on the handle portion of the apparatus for applyingsurgical clips to body tissue.

In aspects, the ratchet assembly may further include a second biasingelement that is disposed within the slot of the pawl and that isinterposed between the shaft of the handle portion of the apparatus forapplying surgical clips to body tissue and a portion of the slot of thepawl. The second biasing element is configured to exert additionalbiasing force on the pawl towards the rack.

In certain aspects, the pawl may be rotatably supported on a shaft. Theshaft is slidably received within a slot defined in the handle portionof the apparatus for applying surgical clips to body tissue.

In aspects, the ratchet assembly may further include a second biasingelement that is disposed within the slot of the handle portion of theapparatus for applying surgical clips to body tissue. The second biasingelement is interposed between the shaft and a portion of the slot toexert additional biasing force on the shaft towards the rack such thatthe tooth of the pawl selectively engage the plurality of ratchet teethof the ratchet to selectively inhibit proximal translation of the rack.

In some aspects, when the rack is urged in a proximal direction, therack may cause the pawl to exert a force that is greater than thebiasing forces of the first and second biasing elements and translate ina direction away from the rack. Further urging the rack in a proximaldirection causes the pawl to disengage from the rack and permit the rackto translate in a proximal direction.

BRIEF DESCRIPTION OF THE DRAWINGS

Various embodiments will be described herein below with reference to thedrawings wherein:

FIG. 1 is a perspective view of a surgical clip applier;

FIG. 2 is another perspective view of the surgical clip applier of FIG.1;

FIG. 2A shows a front view of a display of the surgical clip appliershowing a displayed parameter;

FIG. 3 is an enlarged perspective view of the jaw structure of thesurgical clip applier;

FIG. 4 is a top view of the surgical clip applier;

FIG. 5 is a first side view of the surgical clip applier;

FIG. 6A is a side view, with half of the body removed, of the handleassembly of the surgical clip applier;

FIG. 6B is an opposite side view relative to FIG. 6A with half of thebody removed of the handle assembly of the surgical clip applier;

FIG. 6C is a perspective view of FIG. 6B with half of the body removed,of the handle assembly of the surgical clip applier;

FIG. 7 is a perspective view of the handle housing of the clip applier,with parts separated;

FIG. 7A is a perspective view of the spindle link engaging the spindle;

FIG. 7B is a rear view of the knob with a number of components therein;

FIG. 7C is a perspective view of the knob exploded from a knob housing;

FIG. 7D is a perspective view of the outer tubular member having anotch;

FIG. 7E is a perspective view of the outer tubular member with abushing;

FIG. 7F is a rear view of the knob connected to the knob housing andbushing of FIG. 7E;

FIG. 7G shows a view of a spindle link connecting to the driver bar;

FIG. 7H shows a cross sectional view of the spindle link connecting tothe driver bar along line 7H-7H of FIG. 7G;

FIG. 8 is a perspective view of a pawl;

FIG. 9 is a perspective view of a driving member;

FIG. 9A is a perspective view of an actuator plate;

FIG. 9B is a perspective view of a signaling device;

FIG. 9C is a perspective view of a LCD lever;

FIG. 9D is a perspective view of a wishbone link;

FIG. 10 is a perspective view, with parts separated, of the surgicalclip applier;

FIG. 10A is a perspective view of a feed bar;

FIG. 10B is a perspective view of a follower and surgical clips;

FIG. 10C and 10D are opposite perspective views of a trip block;

FIG. 10E is a perspective view of a spindle;

FIG. 10F is an enlarged area of detail of FIG. 10E;

FIG. 10G is an enlarged area of detail of FIG. 10E;

FIG. 11 is a perspective view of the distal end of the spindle and adriver;

FIG. 12 is a perspective view of a trip lever with the trip lever springon the spindle;

FIG. 13 is a perspective view of a wedge plate;

FIG. 13A is a perspective view of a “C” shaped window on the wedge plateof FIG. 13;

FIGS. 14 and 15 are opposite perspective views of a filler component;

FIG. 14A is an exploded view of a rotatable member being above a springbar member in the filler component;

FIG. 16 is a perspective view of the rotation assembly;

FIG. 17 is a perspective view of the overpressure assembly;

FIG. 18 is a perspective view of the spindle and jaw assembly;

FIG. 19 is an enlarged area of detail of the spindle and jaw assembly ofFIG. 18 with a feed bar and a pusher connected to the feed bar;

FIG. 20 is an enlarged area of detail of FIG. 18;

FIG. 21 is an enlarged view of the distal end of the surgical clipapplier with outer member removed;

FIG. 22 is a perspective view of the surgical clip applier with partsremoved showing a clip channel member and a follower biasing a number ofclips;

FIG. 23 is an enlarged area at detail of FIG. 22;

FIG. 24 is an enlarged area of detail of FIG. 22;

FIG. 25 is an enlarged area of detail of FIG. 22;

FIG. 26 is a perspective view of the spindle, driver and jaw assembly;

FIG. 27 is an enlarged area of detail of FIG. 26;

FIG. 28 is a perspective view of the cam link and wedge plate assembly;

FIG. 29 is an enlarged area of detail of FIG. 28;

FIG. 30 is an enlarged area of detail of FIG. 29;

FIG. 31 is a perspective view of the filler component and jaw assembly;

FIG. 32 is an enlarged perspective view of the jaw assembly of FIG. 31;

FIGS. 33 and 34 are perspective views of the distal end of the spindleincluding wedge plate and driver with the wedge plate removed in FIG.33;

FIG. 35 is a side view, partially shown in section, of the surgical clipapplier in a pre-fired condition;

FIG. 36 is in enlarged area of detail of FIG. 35;

FIG. 36A is a first lateral side view of a lockout mechanism;

FIG. 36B is a second opposite lateral side view of FIG. 36A showing thelockout mechanism;

FIG. 36C is another first lateral side view of FIG. 36A showing thelockout mechanism having a ratchet arm;

FIG. 36D is a cross sectional view of the lockout mechanism along line36D-36D of FIG. 36C;

FIG. 36E is a perspective view showing a first rotatable member, asecond rotatable member and a third rotatable member of the lockoutmechanism;

FIG. 36F is a perspective view of a first rotatable member of thelockout mechanism;

FIG. 36G is a perspective view of a third rotatable member of thelockout mechanism;

FIG. 36H is a perspective view of the second rotatable member of thelockout mechanism having a notch;

FIG. 36I is a perspective view of the second rotatable member of thelockout mechanism being opposite the view of FIG. 36H showing a numberof teeth;

FIG. 37 is an enlarged area of detail of FIG. 35;

FIG. 38 is in enlarged area of detail of FIG. 37 showing the trip lever;

FIG. 39 is an enlarged area of detail of FIG. 37 showing the follower;

FIG. 40 is a side view, shown in section, of the distal end of thesurgical clip applier of FIG. 37 having a cam link;

FIG. 41 is an enlarged area of detail of FIG. 40;

FIG. 41A is a top view of the filler component with the rotatable memberengaging the spring bar member;

FIG. 41B is a cross sectional view of the distal end of the surgicalclip applier along line 41B-41B of FIG. 41;

FIG. 42 is a side view, shown in section, of the distal end of thesurgical clip applier of FIG. 37 with the feed bar engaging a clip;

FIG. 42A is an enlarged area of detail of FIG. 42;

FIG. 43 is a perspective view of the wedge plate and jaw assembly;

FIG. 44 is an enlarged area of detail of FIG. 43;

FIG. 45 is a top view of FIG. 43 taken along line 45-45;

FIG. 46 is an enlarged area of detail of FIG. 45 showing the jaw and thewedge plate;

FIG. 47 is an enlarged area of detail of FIG. 45 showing the wedge plateand cam link;

FIG. 48 is a side view, shown in section, of the handle housing at thebeginning of an initial stroke;

FIG. 49 is an enlarged area of detail of FIG. 48 showing the rack andpawl;

FIG. 49A is an enlarged area of detail of FIG. 48 showing the audibleclick lever and rib;

FIG. 50 is an enlarged area of detail of FIG. 48 similar to FIG. 49;

FIG. 50A is an enlarged area of detail of the lockout mechanism of FIG.48;

FIG. 51 is a side view, shown in section, of the feed bar and triplever;

FIG. 52 is a side view, shown in section, of the follower;

FIG. 53 is a side view, shown in section, of the endoscopic portion ofthe surgical clip applier with the spindle and the cam link;

FIG. 54 is an enlarged area of detail of FIG. 53 illustrating thespindle movement;

FIG. 55 is a top view of the wedge plate and filler componentillustrating the movement of the cam link in the cam slot;

FIG. 56 is a side view, shown in section, illustrating the feed baradvancing a clip;

FIG. 57 is a top view of the wedge plate and cam link moving distallyand the wedge plate moving relative to the follower with the rotatablemember rotating and contacting the spring bar member;

FIG. 58 is a side view, shown in section, illustrating a clip enteringthe jaws;

FIG. 59 is a further top view of the cam link and wedge plate movementwith the camming feature of the spindle contacting the cam link;

FIG. 60 is a top view of the wedge plate entering the jaw structure;

FIG. 61 is a perspective view illustrating the rounded distal end of thewedge plate opening the jaw structure for loading;

FIG. 62 is a top view illustrating further advancement of the cam linkin the cam slot of the wedge plate;

FIG. 63 is a side view, shown in section, illustrating the trip leverengaged with the feed bar;

FIG. 64 is a side view, shown in section, illustrating a clip thatentered the jaws with the feed bar at a most distal position;

FIG. 65 is a top view illustrating the rotatable member in the “C”shaped window of the wedge plate;

FIG. 65A is a bottom view illustrating the rotatable member in the “C”shaped window of the wedge plate deflecting the spring bar member of thefiller component;

FIG. 66 is a side view, shown in section, illustrating the trip leverbeing cammed out of engagement with the feed bar;

FIG. 67 is a side view, shown in section, illustrating the retraction ofthe wedge plate and feed bar;

FIG. 67A is a side view of the handle housing with the trigger at agreater stroke;

FIG. 68 is a side view, shown in section, illustrating furtheradvancement of the spindle;

FIG. 69 is a side view, shown in section, illustrating the retraction ofthe wedge plate and further advancement of the spindle;

FIG. 70 is a perspective view of the wedge plate retracting from the jawstructure;

FIG. 71 is a side view, shown in section, with the spindle engaging thedriver and a driver lockout member engaging the spindle;

FIG. 71A is a side view of the handle section with the click leverrotatable to contact the rib in the housing for an audible alarm;

FIG. 72 is a side view of the handle housing with the trigger at fullstroke;

FIG. 73 is a side view, shown in section, of the driver camming the jawsclosed about a surgical clip;

FIGS. 74 to 76 are sequential views of the driver camming the jawsclosed about a surgical clip;

FIG. 77 is a view, shown in section, of the overpressure mechanismincluding the impact spring;

FIG. 78 is a perspective view of a surgical clip formed on a vessel;

FIG. 79 is an enlarged area of detail of the pawl resetting;

FIG. 80 is a side view, shown in section, illustrating the spindleretracting;

FIG. 81 is a top view illustrating the rotatable member of the fillercomponent resetting;

FIGS. 82 and 83 are top views illustrating the cam link resetting withinthe wedge plate;

FIGS. 84 through 86 are side views illustrating the lockout mechanismrotating and the shaft portion of the first rotatable member traversingthrough the escape notch to engage a corresponding notch in the triggerto prevent the trigger from firing;

FIG. 87 is an exploded view of another embodiment of the clip applierwith a filler component, a wedge plate, a link cam and a spindle;

FIG. 88A is a top view of the filler component resting on the wedgeplate and on the spindle;

FIG. 88B is a top view of the link cam and the wedge plate resting onthe spindle with the filler component removed;

FIG. 88C is a top view of the link cam and the wedge plate resting onthe spindle with the cam slot of the spindle being shown in phantomlines for illustration purposes;

FIG. 89 is a close up view of the link cam engaging the wedge plate andtraversing in the cam slot of the spindle along window 89 of FIG. 88C;

FIG. 90 is a perspective view of a first component of an alternativesignaling device of the present clip applier;

FIG. 91 is a top view of the first component of the signaling device ofFIG. 90;

FIG. 92 is a side view of the first component;

FIG. 93 is a front view of a channel of the first component;

FIG. 94 is a perspective view of a second component of the alternativesignaling device of the present clip applier;

FIG. 95 is a perspective view of the handle portion of the present clipapplier with a rib portion and a lateral click strip;

FIG. 96 is a perspective view of the handle portion having the assembledsignaling device;

FIG. 97 is a perspective view of a clip applied to a vessel;

FIG. 98 is a side view of a spring;

FIG. 99 is a top view of a clip carrying channel according to anotherembodiment of the present disclosure;

FIG. 100 shows an enlarged view of the clip carrying channel of FIG. 99;

FIG. 101 illustrates a top view of a lockout bar;

FIG. 102 shows a side view of the lockout bar of FIG. 101;

FIG. 102A is a perspective view of the lockout bar of FIG. 101;

FIG. 103 shows a partially assembled view of the lockout bar of FIGS.101 and 102 and the spring of FIG. 98;

FIG. 104 is a top view of a clip follower;

FIG. 105 shows a side view of a feed bar having a distal nose and a pairof proximal fins;

FIG. 106 shows a top view of the lockout bar of FIG. 101 in a channel ofthe clip follower;

FIG. 107 illustrates the lockout bar extending into the distal apertureof the feed bar;

FIG. 108 illustrates another view of the embodiment of the clip applierhaving the lockout bar extending into the distal aperture of the feedbar;

FIG. 109 illustrates another view of the embodiment of the clip applierhaving the cover removed and showing the lockout bar extending into thedistal aperture of the feed bar;

FIG. 110 illustrates another view of the embodiment of the clip applierhaving the cover and feed bar removed and showing the lockout bar in thefeed bar;

FIG. 111 illustrates another a bottom view of the clip follower with thelockout bar and spring in the channel of the clip follower;

FIG. 112 is a cross sectional view of the clip follower having thelockout bar and the spring in the channel along line 16-16 of FIG. 111;

FIG. 113 is a top view of the feed bar having a distal nose and a distalaperture;

FIGS. 114 through 115 are a cross sectional view and bottom view of thespindle of the clip applier having a proximal window;

FIG. 116 is an enlarged view of the window of the spindle of FIG. 114;

FIG. 117 is a side view of the pawl and rack being reset or in the “atrest” or home position;

FIG. 118 is a side view of the pawl and rack being in the intermediateposition and configured to prevent retraction of the spindle;

FIG. 119 is a perspective view of a shear pin according to the presentdisclosure;

FIG. 120 is a side cross-sectional view of the clip applier illustratingthe rack and pawl locking out the spindle;

FIG. 121 is a side cross-sectional view of the clip applier illustratingan initial movement of the trigger;

FIG. 122 is a side cross-sectional view of the clip applier illustratinga further movement of the trigger;

FIG. 123 is a side view of a ratchet assembly including an overridefeature provided in accordance with the present disclosure;

FIG. 124 is a side view of the ratchet assembly of FIG. 123 showing apawl of the ratchet assembly in an articulated position caused by a rackof the ratchet assembly translating in a distal direction;

FIG. 125 is a side view of the ratchet assembly of FIG. 123 showing thepawl in an actuated position caused by the rack translating in aproximal direction;

FIG. 126 is a side view of the ratchet assembly of FIG. 123 showing thepawl having a biasing element coupled thereto;

FIG. 127 is a side view of another embodiment of a ratchet assemblyincluding an override feature provided in accordance with the presentdisclosure;

FIG. 128 is a side view of the ratchet assembly of FIG. 127 shown with apawl of the ratchet assembly removed;

FIG. 129 is a side view of the ratchet assembly of FIG. 127 showing thepawl in an articulated position caused by a rack of the ratchet assemblytranslating in a distal direction; and

FIG. 130 is a side view of the ratchet assembly of FIG. 127 showing thepawl in an actuated position caused by the rack translating in aproximal direction.

DETAILED DESCRIPTION OF THE EMBODIMENTS

There is disclosed a novel endoscopic surgical clip applier having a jawcontrol mechanism configured to maintain jaws of the surgical clipapplier in a spaced apart and stable position during insertion of asurgical clip. The novel endoscopic surgical clip applier also has alockout mechanism. The lockout mechanism prevents the surgical clipapplier from firing when there are no remaining hemostatic clips. Thenovel endoscopic surgical clip applier also has a signaling device foralerting the surgeon that a clip has been fired. It should be notedthat, while the disclosed jaw control mechanism, the driver lockout andthe signaling device are all shown and described in an endoscopicsurgical clip applier, the disclosed mechanisms are applicable to anysurgical clip applier or another instrument having a pair ofcompressible jaws. Reference should be made to the drawings where likereference numerals refer to similar elements throughout the variousfigures.

There is disclosed a novel endoscopic surgical clip applier of thepresent disclosure. Referring now to FIG. 1, the surgical clip applier10 generally has a handle assembly 12 and an endoscopic portion with anelongated tubular member 14 that extends distally from the handleassembly 12. The handle assembly 12 is made from a thermoplasticmaterial and the elongated member is made from a biocompatible material.In one embodiment, the material may be a stainless steel or in yetanother embodiment a titanium material or alloy. A pair of jaws 16 ismounted on the distal end of the tubular member 14. The jaws 16 areactuated by a trigger 18. The trigger is movably mounted in handleassembly 12.

The jaws 16 are also formed from a suitable biocompatible material suchas stainless steel, titanium or a suitable alloy. The endoscopic portionalso has a knob 20. The knob 20 is rotatably mounted on a distal end ofthe handle assembly 12 and is connected to the elongated tubular member14 to provide a three hundred sixty degree rotation of the elongatedtubular member 14 and the jaws 16 thereon relative to a longitudinalcenter axis of the elongated tubular member 14. A significant aspect ofthe clip applier 10 is that the knob 20 has a suitable configuration soas to be rotated simply using a surgeon's finger, and will be discussedin depth below.

Referring now to FIG. 2, the endoscopic surgical clip applier 10 has adisplay 22. The display 22 may be any device known in the art to providean indication of an event. The event may be related to the procedure orthe operation of the clip applier 10. The display 22 in a preferredembodiment may be a liquid crystal display. However, in anotherembodiment, the display 22 may be a plasma display, one or more lightemitting diodes, a luminescent display, a multi-color display, a digitaldisplay, an analog display, a passive display, an active display, a socalled “twisted nematic” display, a so called “super twisted nematic”display, a “dual scan” display, a reflective display, a backlit display,an alpha numeric display, a monochrome display, a so called “LowTemperature Polysilicon Thin Film Transistor” or LPTS TFT display, orany other display 22 that indicates a parameter, information or graphicsrelated to the procedure or the clip applier 10. In one embodiment, thedisplay is a liquid crystal display 22 or “LCD”. The LCD 22 may be ablack and white or color display that displays one or more operatingparameters of the clip applier 10 to the surgeon. Referring now to FIG.2A, there is shown a front view of the LCD display 22. The display 22shows a displayed parameter. In one embodiment, the displayed parametermay be an amount of remaining clips, a number clips that have been used,a position parameter, a surgery time of usage, or any other parameter ofthe procedure. The LCD 22 may display text, a graphic or a combinationthereof. In one embodiment, the LCD 22 may have a tab made from a Mylaror another polymeric insulating material that is disposed between a LCD22 battery and a contact of the LCD 22 to prevent the battery from beingdrained during storage. The tab may extend out of the clip applier 10 inorder to allow for removal of the tab. Once removed, the tab will bepulled out from the clip applier 10 and will permit the battery tocontact the electrical contact of the LCD 22 to energize the LCD 22 withpower. In one embodiment of the present clip applier 10, the LCD 22 hasa lens that magnifies the display. The lens of the LCD 22 may magnifythe display to any desired size in order to allow a surgeon to read thedisplay with ease from a distance. Referring now to FIG. 3, the jaws 16have a channel 24 for receipt of a single surgical clip therein. As isknown, a surgical clip may be applied or placed in the channel 24 by aloading structure of the clip applier 10 to apply the hemostatic clipin, for example, a body cavity.

Referring now to FIG. 6A, the handle assembly 12 of the endoscopicsurgical clip applier 10 is shown from a first open lateral side of thehandle assembly 12. The endoscopic surgical clip applier 10 has thetrigger 18 connected to a wishbone link 26. The wishbone link 26 is amember that on one end is connected to the trigger 18 through a triggerslot 28 and on an opposite end has first and a second wishbone shapedmembers 30, 32. The first and a second wishbone shaped members 30, 32form a space 34 for receipt of a driving member 36.

The driving member 36 is a substantially flat member that islongitudinally disposed in the handle assembly 12 as shown and isintended to move one or more driving structures to load, and actuate thejaws 16 to form a fully formed clip, and then reset to an initialposition for the next clip application. A return spring 38 is disposedto surround the driving member 36. The driving member 36 is connected toa driving mechanism to fire the clip applier 10 and is suitablyconnected such that after the trigger 18 is actuated and the wishbonelink 26 advances the driving member 36 in a longitudinal or distalmanner, the return spring 38 will return the driving member 36 and thetrigger 18 to its original position for the next clip application.

The driving member 36 is advantageous. The driving member 36 prevents aninadvertent return of the trigger 18 before a full actuation of the openclip applier 10 by impeding movement at an intermediate position oncethe driving member 36 begins to advance distally. The driving member 36has a rack 40. The rack 40 is disposed on a top side 42 thereof.

The rack 40 has a number of teeth 44 and the teeth 44 are engaged toengage with another complementary surface to prevent inadvertent returnof the trigger 18 and the driving member 18 before a full actuation ofthe surgical clip applier 10. The surgical clip applier 10 has a pawl 46with a pawl return spring 48. The pawl 46 is biased with the pawl spring48 to engage with the teeth 44 of the rack 40. The teeth 44 and the pawl46 prevent a release of the trigger 18 before a full actuation of thetrigger 18 as described herein below.

Referring now to FIG. 6B, the clip applier 10 further has an actuatorplate 50. The actuator plate 50 is longitudinally disposed in the handleassembly 12. The actuator plate 50 is disposed below the driving member36 and is operatively connected to a LCD lever 52.

Referring now to FIG. 6B, the LCD lever 52 is a suitable structure to beoperatively connected to the LCD display 22. Lever 52 moves a suitablemechanism or contact in the LCD display 22 to permit the LCD display 22to be actuated and thus display one or more operating parameters of theclip applier 10. In one embodiment, the actuator plate 50 is connectedto the LCD lever 52 to move the corresponding LCD display 22 structureor contact to display an amount of remaining clips that the surgeon hasto fire. In another embodiment, the display may be a number of lightemitting diodes, a liquid plasma display, an electronic device ordisplay, a changeable display or a combination thereof.

Referring now to FIG. 6C, the actuator plate 50 further has a signalingdevice 54. The signaling device 54 is a device that is connected to theactuator plate 50 and that can provide the user with an audible signalthat the open clip applier 10 has fired the surgical clip. The signalingdevice 54 emits a sound once the clip applier 10 is fired to provideaudible feed back to the surgeon. In another embodiment, the signalingdevice 54 may be another electronic device that emits a characteristicsound. The signaling device 54 may emit a sound in response to adeflection of the handle or trigger, a compression of a clip, a loadingof the clip, a loading of a new clip, an exhaustion of all of the clips,or may emit several different sounds depending on the clip applier 10event. The characteristic sound may be a click, a chirp, a sound, avoice, a recording, a combination of sounds, or any acoustic wave at anydecibel level. The signaling device 54 may further provide anidentification in response to an event of the clip applier 10. In oneembodiment, the signaling device 54 may emit a sound during normaloperation, and then upon the occurrence of the event terminate emittingthe sound. Various configurations are possible and all within the scopeof the present disclosure.

Referring still to FIG. 6C, the clip applier 10 further has a lockoutmechanism 56. The lockout mechanism 56 is a structure to prevent thesurgeon from dry firing the open clip applier 10 when the amount ofclips stored in the clip applier 10 have been exhausted. The lockoutmechanism 56 engages a complementary structure in the trigger handle Ato prevent the trigger 18 from further moving and actuating the wishbonelink 26 in a manner described in more detail below.

Referring now to FIG. 7, there is shown an exploded view of the handleassembly 12 from an opposite side. The surgical clip applier 10 has theactuator plate 50 that is a substantially “S” shaped member. As bestshown in FIGS. 7 and 9A, the actuator plate 50 has a first portion 58having a first orthogonal shaped window 60 and a second portion 62 witha second orthogonal shaped window 64.

On a first end of the actuator plate 50, the actuator plate 50 has arounded off or curved portion that forms a pair of tines 66. Theopposite second end 68 has a protrusion 70. The protrusion 70 engages achannel 72 on the LCD lever 52. A pin 74 is disposed through the firstorthogonal shaped window 60 to connect the actuator plate 50 to thedriving member 36 through the wishbone link 26. In this manner, when thetrigger 18 moves the driving member 36 distally, the connecting pin 74upon being moved through the first window 60 will also move the actuatorplate 50 distally in a similar fashion once the connecting pin 74contacts an outer distal edge 76 of the first orthogonal shaped window60.

Referring again to FIGS. 7, and 9B, the clip applier 10 further has thesignaling device 54 with an audible click lever 78. The audible clicklever 78 is on an opposite side of the actuator plate 50 and is throughthe second window 64. The signaling device 54 also has an audible clickspring 80. The signaling device 54 also has the audible click lever 78that will rotate and deflect on a complementary handle surface uponlongitudinal distal movement by the actuator plate 50. The actuatorplate 50 will move the second window 64 having a lateral side 82 (shownin FIG. 9A) that will cause a post 77 of the audible click lever 78(FIG. 9B) to deflect and cause the lever 78 to contact a surface rib onthe housing. This contact produces an audible alert or an audible signalto the surgeon that the clip applier 10 has fired a surgical clip.

Referring to FIG. 7, the clip applier 10 further has the LCD lever 52(best shown in FIG. 9C) that is a rotatable member with a first leverportion 84, an aperture 86 and a curved member 88 having the channel 72.The channel 72 communicates with the protrusion 70 on the actuator plate50 and has a peg 92 that communicates with the first handle housingportion 94 shown in FIG. 7.

Referring to FIG. 7, the LCD 22 has a LCD unit 96 with an LCD lens 98and a LCD counter contact plate 100 that is connected to the LCD 22. TheLCD counter contact plate 100, upon being actuated will toggle the LCDdisplay 22 from a previous parameter to the current parameter, such asin one embodiment, an amount of remaining clips in the clip applier 10.

The clip applier 10 also has the pawl 46 with the pawl spring 48. Thepawl 46 has an end that engages with the teeth 44 of the rack 40.

Referring to FIG. 7, the clip applier 10 further has the lockoutmechanism 56 having a first rotatable member or shaft 102 with an arm104 and a pawl 106 connected to the arm 104. The first rotatable member102 is generally cylindrical shaped and is connected to a complementarysurface of the handle through a spring 105. In one embodiment, the firstrotatable member 102 is a lock out arm

The lockout mechanism 56 further has a second rotatable member 112offset from the first rotatable member 102. The second rotatable member112 in one embodiment is a lockout wheel and has a generally circularconfiguration with an inner circumference 114 of the lockout wheel 112having a number of teeth 116 spaced therearound. The lockout wheel 112has a centermost post 118 that is connected through an aperture to athird rotatable member 120 having a first arm 122 connected thereto, andthe post 118 is further connected to the handle portion 12. As thetrigger 18 is fired, there exists a relative movement between the firstrotatable member 102 connected to the handle portion 12 and the thirdrotatable member 120 connected to the trigger 18. As such, the lockoutwheel 112 is intended to rotate a predetermined amount as the centermostpost 118 is connected to the handle portion 12. As the lockout wheel 112rotates, the pawl 106 of the first rotatable member 102 will advance.Each time the trigger 18 is fired to fire a clip; the pawl 106 willtraverse one unit of length between the number of teeth 116 and willrest therein due to an advantageous ratcheting arrangement discussedherein. The lockout wheel 112 has an escape notch 110 that is anorthogonally shaped notch 110 on a radial portion thereof. Escape notch110 permits the pawl 106 of the first rotatable member 102 to traversefrom an inner location or the inner circumference 114 of the lockoutwheel 112 outward through the escape notch 110 to engage thecomplementary structure in the trigger shown by reference letter A toprevent the trigger 18 from further moving and actuating the wishbonelink 26.

The clip applier further has the knob 20 having a shaft assembly 124. Aspindle link 126 connects to a spindle 128 shown in FIG. 7A. Referringnow to FIG. 7G and FIG. 7H, the driver bar 36 connects with the spindlelink 126. The spindle link 126 on a proximal side opposite the jaws 16has spindle link hook 185. The driver bar 36 has an angled hook member186. The angled hook member 186 is on a distal side 184 of the driverbar 36. Referring now to the cross sectional view along line 7H-7H ofFIG. 7G, the angled hook member 186 of the driver bar 36 mates with thespindle link hook 185. As shown, the driving member 36 can thus advancethe spindle link 126 in a distal manner. Referring now again to FIG. 7A,an opposite distal end of the spindle link 126 (relative to the spindlelink hook 185) is connected with a circular boss connection 188 to thespindle 128. In this manner, the spindle 128 may rotate independently ofthe spindle link 126 as shown by the reference arrow B.

Referring now to FIG. 7B, there is shown a cross sectional view of theknob 20 along line 7B-7B of FIG. 5. The knob 20 has a first body half130 and a second body half 132 connected to one another in an apertureor bore 134 of the knob 20.

Referring now to FIG. 7C, the knob 20 connects with a knob housing 136having a planar tapered surface 138 that connects with the knob 20.Referring again to FIGS. 7B and 7C, the knob 20 has the bore 134disposed therethrough. The knob housing 136 further has an outer tubularmember 142 with a first slot 144 and a second slot 146 disposed throughthe tubular member 142 with the outer tubular member 142 having a “C”shaped first aperture 148 and a second “C” aperture 150 on respectiveopposite laterals sides thereof.

Notably, the knob housing 136 is very advantageous as the knob housing136 has an elongated cylindrical geometry that is suitable to allow asurgeon to rotate the tubular member 14 simply with one hand by using anindex finger to contact a lateral side of the knob 20 and rotate theknob 20 either in a clockwise or a counter clockwise manner. Thisobviates any two handed operation to rotate the tubular member 14 thatis disfavored by some surgeons and provides for a more ergonomicoperation or rotation of the tubular member 14.

Referring now to FIG. 7C, the knob 20 on an inner surface of the bore134 has a first arm 152 and a second arm 154 that extend opposite anouter surface into the bore 134 for respectively mating with the first“C” shaped aperture 148 and the second “C” shaped aperture 150 of theknob housing 136.

Referring again to FIG. 7B and 7E, the outer tube 14 further has abushing 156 with a first aperture 158′ and a second aperture 160′ with afirst pin 162 extending through the first aperture 158′ and a second pin164 extending through the second aperture 160′. Referring now to FIG.7E, the bushing 156 further has a tab 166 that extends from a radialposition of the bushing 156. The tab 166 engages with a notch in theknob housing 136. The bushing 156 also has a second tab 166′. The secondtab 166′ also engages a notch 168 in the tubular member 14 shown in FIG.7D for rotation thereof. In order to actuate the various components, thespindle 128 is mounted for longitudinal movement through the tubularmember 14.

Referring now to FIG. 8, there is shown a perspective view of the pawl46 previously described. The pawl 46 is a triangular shaped member withan aperture 169 disposed therethrough. The pawl 46 also has a number ofangled surfaces 170, 172, 174 on a top side 176 and a tooth engagingstructure 178 on an opposite bottom side 180 for engaging with the teeth44 on the rack 40 as shown in the driving member 36 of FIG. 6D. Asshown, the driving member 36 has an aperture 182 for mating with thewishbone link 26 of FIG. 9D and has a first side 181 and an oppositesecond side 184 with an angled hook member 186 for advancement of thespindle 128 in a distal manner.

Referring now to FIG. 9D, the wishbone link 26 is connected to thedriving member 36 through the first longitudinal shaped window 60 ofFIG. 9A on the actuator plate 50 by means of the pin 74. The actuatorplate 50 with the protrusion 70 connects with the channel 72 in the LCDlever 52 of FIG. 9C and the actuator plate 50 is further connected tothe signaling device 54 shown in FIG. 9B. The signaling device 54 has anaperture 188 for mating with the handle housing. The audible click lever78 has a bulbous end 190 with a resilient surface 191 such that uponrotation of the click lever 78 the bulbous end 191 can sharply contactanother handle surface or rib in order to an acoustic wave to emanatefrom the handle assembly 12 to signal that the surgical clip has fired.The signaling device 54 further has the post 77 is connected through thesecond window 64 of FIG. 9A and that rotates the lever 54 when theactuator plate 50 moves distally.

Referring now to FIG. 10 there is shown an exploded view of the variouscomponents of the endoscopic portion 16 of the open clip applier 10. Theclip applier 10 has the outer tubular member 14. The outer tubularmember 14 is generally a cylindrical member having a first end 192 and asecond end 194. The first end 192 is connected through the bore to thespindle link 126. As mentioned, the spindle link 126 is connected to thespindle 128. The outer tube 14 is disposed around the spindle 128. Theclip applier 10 has pins 162, 164. The pins 162 and 164 extend throughthe lateral sides of the bushing 156. The pins 162, 164 are biasedinward relative to the bushing 156 and contact the outer tubular member14. The clip applier 10 further has a spring 196 to prevent the bushing156 from advancing. The spring 196 is disposed in the knob housing 136that connected to the knob 20.

The clip applier 10 further has the interlocking spindle link 126 thatis disposed through the bore of the elongated tubular member 14. Thepresent clip applier has a number of different assemblies in order toperform a number of different clip applier functions. The clip applier10 has a spindle mechanism 128 in order to traverse through the tubularmember 14 to actuate a driving mechanism to close the jaws 16 and form afully formed clip. The clip applier 10 also has a mechanism for awedging function that is provided to maintain the jaws 16 in a spacedapart condition for loading the jaws 16 that retracts once the jaws 16are loaded. The clip applier 10 also has a feeder function that feedsclips to the jaws 16. The clip applier also has a clip storage functionand a clip follower function that biases the stored clips for subsequentloading thereof.

In order to actuate the various components there is provided anactuation mechanism or the spindle 128 shown above the knob 20 in FIG.10. The spindle 128 is mounted for longitudinal distal and proximalmovement through the elongated tubular member 14. The spindle 128 has,on a distal end 204, a camming mechanism with a driver bar 200 and aslider joint 202 that extends from a distal end 204 of the spindle 128to selectively engage the camming surfaces and to close the jaws 16around the surgical clip.

The spindle 128 further has a latch member 206 on the slider joint 202and a cam link 208 on the spindle 128. The latch member 206 cams in adirection toward the spindle 128. The latch member 20 cams into acorresponding slot of the spindle 128. The latch member 206 permits thedriver bar 200 to move distally. The latch member 206 also prevents thedriver bar 200 from actuating the jaws 16 when spindle 128 movesdistally to reduce a predetermined dwell distance between the spindle128 and the driver bar 200. The spindle 128 also has a camming feature210 or bulging edge to move another structure in a perpendicular mannerrelatively to a longitudinal axis of the spindle 128 during a distaladvancement.

The clip applier 10 retains one or a number of surgical clips 300 forapplication to the desired tissue. The clip applier 10 has an elongatedclip channel member 302 for retaining a number of surgical clips 300shown in an aligned manner above the clip channel member 302. Theelongated clip channel member 302 does not move longitudinally relativeto the elongated tubular member 14. The clip applier 10 has a follower306 connected to a follower spring 308. The follower spring 308 urgesclips distally in the clip channel member 302. The clip applier 10 alsohas a channel cover 310 that overlies the clip channel member 302 toretain and guide the follower 306 and the follower spring 308 and theclips 300 distally in the clip channel member 302. The clip applier 10also has a nose 312 to direct the clips 300 traversing through the clipchannel member 302 into the channel 24 between the jaws 16.

The clip applier 10 also has a feed bar 400 for feeding clips 300 intothe channel 24 between the jaws 16. The feed bar 400 also provides for arelative movement. Referring now to a distal portion of clip channelmember 302, there is shown the feed bar 400. The feed bar 400 at thisdistal location advances the clips 300 into the channel 24 and betweenthe jaws 16. Referring now to a proximal location opposite the jaws 16,the feed bar 400 has a pusher spring 402 (FIG. 10). The pusher spring402 biases the feed bar 400 in a longitudinal distal direction. Thepusher spring 402 is disposed in a complementary location under a notch404 in a trip block 406. On a distal side of the trip block 406, thetrip block 406 is adjacent to the clip channel cover member 304. Thefeed bar 400 is shown above the trip block 406. The feed bar 400 has ahook 408. The hook 408 engages in the notch 404 of the trip block 406.The clip applier 10 further has a guide pin 401. The guide pin 401 isdisposed through the pusher spring 402 and necessary to align the pusherspring 402. The hook 408 engages with the guide pin 401 and the pusherspring 402 under the trip block 406. In this manner, the hook 408 isdisposed through the notch 404 to engage the guide pin 401. The pusherspring 402 and guide pin 401 biases the feed bar 400 and permits thefeed bar 400 to advance distally. Moreover, the guide pin 401 beingdisposed through the pusher spring 402 allows for a self-containedassembly. In order for spindle 128 to advance the pusher 400, thespindle 128 has a trip lever 500 and a biasing spring 502. The triplever 500 is engaged with the feed bar 400 to advance the surgical clips300 distally into the clip channel 24 between the jaws 16.

The clip applier 100 also has a wedge plate 600 with a wedge platespring 602. The wedge plate 600 is a flat bar shaped member having anumber of orthogonally shaped windows 604 disposed therethrough. Thewedge plate spring 602 surrounds a tongue 606 in the wedge plate 600that is in a latch aperture 608. The wedge plate spring 602 permits thewedge plate 600 to be retracted from a distal location to a proximallocation after being advanced distally to separate the jaws 16 for cliploading. The wedge plate 600 also has a “C” shaped window 610 that isbetween the windows 604 and the tongue 606.

The clip applier 10 also has a filler component 700. The fillercomponent 700 has a rotatable member 702 and a spring bar member 704.The spring bar member 704 is in an aperture 706 disposed in the fillercomponent 700. The rotatable member 702 is capable of a certainparticular range of motion and has a first proximal end 708 and a secondopposite distal end 710 that is opposite the first end 708. The range ofmotion of the rotatable member 702 may be any relatively slight or anyrelatively large range of rotation or movement. The present clip applier10 is not limited in any manner to any specific degree of rotation orany specific manner of movement such as circular, elliptical or even anygeometric rotational pattern, origin, axis, coordinates or movement.Moreover, the member 702 may alternatively simply move in any planar orin another irregular manner known in the art. Various configurations arepossible and within the scope of the present disclosure.

The clip applier 10 further has the jaws 16. The jaws 16 are made of afirst jaw member 16 a and a second jaw member 16 b. Between the firstjaw member 16 a and the second jaw member 16 b is the clip channel 24.As is understood, the jaw members 16 a and 16 b can move inwardly toclose and compress to form a fully formed clip in the channel 24. Thejaws 16 also have a first raised camming surface 212 and a second raisedcamming surface 214 on an outer surface thereof. The first raisedcamming surface 212 and the second raised camming surface 214 permitanother driving camming surface selectively engagement therewith forclosing and compressing the jaws 16.

Referring now to FIG. 10A, there is shown a view of the feed bar 400.The feed bar 400 is a longitudinal member having the rectangular shapedwindow 410 for engagement with the trip lever 500. The feed bar 400 alsohas the hook 408 disposed on a bottom side 412 of the feed bar. The feedbar 400 further has a pusher 414 on a distal end for engaging andmanipulating the surgical clips 300 in the clip carrying channel 302.

As shown in FIG. 10B, the feed bar 400 cooperates with the follower 306that slides in the clip carrying channel 302 for pushing and urging theclips 300 distally in the clip carrying channel 302. As shown in FIGS.10C and 10D, there is shown the trip block 406 both in a first positionand in an opposite second position.

As discussed above, the trip block 406 has the notch 404 therein andalso has an angled surface forming a first and second toothed member420. Each of the first and the second toothed members 420 is forengagement with the corresponding surface of the trip lever 500 thatwill be discussed herein. The notch 404 of the trip block 406 in FIGS.10C and 10D is for receipt of the hook 408 of the feed bar 400 shown inFIG. 10A. In order to disengage the trip lever 500 from the window 410of the feed bar shown in FIG. 10A, the trip block 406 of FIG. 10C and10D has the first and second toothed member 420 that engage the triplever 500 shown in FIG. 10. First and second toothed member 420disengages the trip lever 500 from the window 410 of FIG. 10A.

Referring now to FIGS. 10E through 10F, there is shown a spindle 128.Referring to FIG. 10 F, the spindle 128 has a first orthogonal cavity222 and a second orthogonal shaped cavity 224 for receiving the triplever 500, and for receiving the trip lever biasing spring 502. Thefirst orthogonal cavity 222 has a pivoting boss 226 (FIG. 10F) to allowthe trip lever 500 to pivot from a first position to a second rotatableposition. The trip lever biasing spring 502 rests in the second cavity224. The spring 502 shown in FIG. 10 rests therein without any boss ormember to connect the biasing spring 502 for ease of manufacture.Referring now to an opposite location of the spindle 128 shown in FIG.10G, the spindle 128 further has a groove 209 with the camming feature210 and another cavity 228 to allow the cam link 208 to rest therein andbe urged distally. The spindle 128 advances distally to engage the drivecomponents of the clip applier 10 as discussed in further detail below.

Referring to FIG. 12, the trip lever biasing spring 502 has a first andsecond bowed ends 504, 506 that interlock with the second cavity 224 ofthe spindle 128 as indicated by a dotted line. The trip lever biasingspring 502 further has a second member 508. The second member 508 biasesoutward opposite a normal surface of the spindle 128. The second member508 contacts the trip lever 500. The trip lever 500 has a C shaped end510 that engages for rotational movement with the pivoting boss 226 ofthe spindle 128 and another end 512 that extends above the trip leverbiasing spring 502. In order to disengage the trip lever 500 with thefeed bar 400, the trip block 406 has an angled surface or toothedsurfaces 420 that can selectively engage the trip lever 500 anddisengage the trip lever 500 from the window 410 of the feed bar 400 asdiscussed previously.

Referring now to FIG. 11, the spindle 128 has the cam link 208 that isengagable with the wedge plate 600. The cam link 208 has a cam link boss230 extending therefrom. The cam link 208 is urged distally by thespindle 128 during the stroke.

The slider joint 202 is connected at a proximal end 248 to the spindle128 at a channel 250. On an opposite side, the slider joint 202 has a“T” shaped end 252. T shaped end 252 is connected to the driver bar 200.The slider joint 202 has a latch member 206 that is a linkage that isdisposed to move through an aperture 254 in the slider joint 202 to linkwith another member and prevent the slider joint 202 from advancing thedriver bar 200, and thus preventing camming surfaces 256 of the driverbar 200 from compressing the jaws 16 during the initial stroke offeeding a clip 300 into the jaws 16.

Referring to FIGS. 13 to 13A, the wedge plate 600 is shown. The wedgeplate 600 has the wedge plate spring 602. The wedge plate spring 602provides for a biasing apparatus of the wedge plate 600. The wedge plate600 is biased by the wedge plate spring 602. The spring 602 surroundsthe tongue 606 as indicated by the dotted line. The wedge plate 600 alsohas a “C” shaped aperture or window 610 therethrough.

The “C” shaped aperture or window 610 selectively engages the rotatablemember 702 of the filler component 700. The wedge plate 600 also has acam slot or groove 612 having a cam surface 614. The cam slot or groove612 has a predetermined shape that control a motion of the wedge plate600. The cam slot or groove 612 cooperates with the cam link 208 in thespindle 128 to move the wedge plate 600 distally and to separate thejaws 16 slightly for loading. The cam surface 614 also cooperates withthe cam link 208 to move the wedge plate 600 proximally within thetubular member 14 so the jaws 16 may compress the clip 300 in thechannel 24 once loaded.

The wedge plate 600 has a rounded distal end 616 for separating the jaws16 for loading. The wedge plate 600 also has a proximal window 622 tolimit retraction of the wedge plate 600.

Referring to FIGS. 14 and 14A, there is shown the filler component 700in a first position and in a second opposite position shown in FIG. 15.The filler component 700 has a C shaped end 712 and a rotatable member702 having an aperture 714 that is connected by a pin 716 in acentermost portion of the filler component 700. The rotatable member 702connects with a corresponding structure in the wedge plate 600 tocontrol a motion of the wedge plate 600. On an opposite side of thefiller component 700 is an aperture 718. The rotatable member 702 has afirst end 708 and an opposite second end 710. The first end 708 isbiased by contact with the spring bar member 704 that allows biasingaction between the spring bar member 704 and the rotatable member 702.

The filler component 700 also has (shown in FIG. 15) a filler componentcam slot 720. The filler component cam slot 720 is configured to receivethe boss 230 of the cam link 208. The filler component 700 also has astop 722 to limit a proximal retraction of the wedge plate 600 and alsohas a member 724. The member 724 engages the wedge plate tongue 606 andthe spring 602.

Referring now to FIGS. 16 through 17, there is shown spindle 128 and therelated drive components. The bushing 156 has the spring 196 beingconnected thereto as shown in FIG. 17 to allow an over stroke conditionof the jaws 16. Spring 196 prevents excessive force from being appliedto the jaws 16.

Referring now to FIGS. 18 through 20, there is shown the spindle 128.The feed bar 400 extends in a downward manner (FIG. 19) so the pusher414 extends into the clip carrying channel 302 to engage a clip 300. Thepusher 414 advances each of the clips 300 in the clip channel member 302into the channel 24 between the jaws 16. Referring to the distal regionof the clip applier 10 shown in FIG. 19, the clip applier 10 has a “C”shaped member 416 that is around the nose 312 that acts as a tissue stopdisposed therearound. As discussed above, the nose 312 assists with asingle clip being introduced in the channel 24. The clip applier 10 alsohas a number of T shaped tabs 418. The tabs 418 are in order to hold theclip carrying channel 302, the channel cover 310 and the nose 312together as an integral unit.

Referring to an opposite proximal side relative to the jaws 16 shown inFIG. 20, the spindle 128 has the trip lever 500. The trip lever 500extends through window 410 of the feed bar 400 as shown to advance thefeed bar 400 distally (through the tubular member 14) and to move thepusher 414 distally to introduce the clips 300 into the channel 24between the jaws 16.

FIG. 21 through 24 shows a number of clips 300 in a clip carryingchannel 302. The clip carrying channel 302 has a number of fingers 420curved therearound (FIG. 23) in order to support and retain the clips300 in the clip carrying channel 302. Referring to FIG. 24, there isshown a partially assembled perspective view of the follower 306. Thefollower 306 is disposed in the clip carrying channel 302 with thefollower spring 308 biasing and advancing the follower 306 in a distaldirection. The follower spring 308 imparts a force on the clips 300 inthe clip channel 302. As shown in FIG. 21, the clip applier 10 has anumber of “T” shaped tabs 418 on the clip channel 302 in order tomaintain the assembly together.

Referring now to FIG. 25, the clip applier 10 has the trip lever 500 onthe spindle 128. The trip lever 500 is a T shaped member that is biasedto deflect opposite the spindle top side, and biased by a trip leverspring 502 as previously discussed. Referring now to FIGS. 26 and 27,the driver bar 200 is disposed to rest on the wedge plate 600 or jaws 16in the assembled position and will traverse distally over the first andsecond raised camming surfaces 212 and 214 to close the jaws 16 andcompress the clip 300 in the channel 24.

Referring now to FIG. 28 through 30, the relative assembled portions ofthe trip block 406, the wedge plate 600, and the filler component 700will now be described. There is shown the wedge plate 600 disposed onthe spindle 128.

Referring to FIGS. 29 and 30, the clip applier 10 has a stop member 618to limit movement of the filler component 700. The filler component 700is disposed beneath the wedge plate 600 in this view. The wedge plate600 has the “C” shaped window 610 with the rotatable member 702 disposedthrough the “C” shaped window 610. The wedge plate 600 also has the camslot 612 having the cam surface 614. The cam link 208 is disposed on atop of the wedge plate 600 in this view. The cam link 208 has the camlink boss 230 that interfaces with the cam slot 612 of the wedge plate600.

Referring to FIG. 29, the wedge plate 600 has the wedge plate spring 602around tongue 606 and the member 724 of the filler component 700 aroundthe tongue 606. In this manner, when the tongue 606 moves distallyrelative to the filler component 700 the wedge plate 600 is biased toreturn proximally. The filler component 700 also has the stop 722 in theproximal window 622 of the wedge plate 600 to further limit distalmovement of the wedge plate 600 relative to the filler component 700.

Additionally, the cam link 208 is also configured to be driven distallyin the cam slot 612. Additionally, the cam link 208 is also configuredto be ride in the filler component cam slot 720 shown beneath the wedgeplate 600 in this view.

As the cam link 208 is driven distally from the advancing of the spindle128, the cam link boss 230 engages the cam surface 614 of the wedgeplate 600 to drive the wedge plate 600 distally. The wedge plate 600will advance distally until it reaches a demarcation line 624 shown inFIG. 30. At the demarcation line 624, the cam link boss 231 will engagea disengaging cam surface 726 of the filler component 700 shown in FIG.30.

The disengaging cam surface 726 is a feature in the filler component camslot 720. Notably, the disengaging cam surface 726 will cam the cam linkboss 231 out of engagement with cam surface 614 of cam slot 612. At thisdemarcation point 624, the wedge plate 600 no longer moves distally.

Referring now to FIGS. 31 through 34, the various assembled portions ofthe wedge plate 600, the filler component 700, and the driver bar 200will be discussed. The wedge plate 600 lies over the filler component700 which is positioned on the spindle 128. The jaws 16 have a pair offlexible legs 17 a, 17 b. The legs 17 a, 17 b are fixed to a base member17 c. The jaws 16 are located at a distal end relative to the flexiblelegs 17 a, 17 b. A pair of locking arms 19 a, 19 b extends from the base17 c and terminates in a pair of tabs 21 a, 21 b. Tabs 21 a, 21 b engagea pair of holes (not shown) in the elongated outer tube 14 in order tosecure the jaws 16 to the elongated tube 14.

The filler component 700 is disposed immediately proximal relative tothe jaws 16 and does not move relative to the elongated outer tube 14.Referring now to FIGS. 31 through 33, there is shown a view of the wedgecomponent 600 disposed over the driver bar 200 and resting on thespindle 128. The wedge plate 600 is under the filler component 700 inFIG. 31. The wedge plate 600 being best shown with the jaws removed inFIG. 33. The jaws 16 are configured to receive the rounded distal end616 of the wedge plate 600. The rounded distal end 616 initiallyseparates the jaws 16. The rounded distal end 616 maintains the jaws 16in a separate and aligned configuration during insertion of the clip 300in the channel 24 of the jaws 16.

The wedge plate 600 has the rounded distal end 616 that maintains thejaws 16 separated and notably prevents any flexing or torque of the jaws16. Each of the jaws 16 has a cam feature 23 a, 23 b to guide therounded distal end 616 of the wedge plate 600 between the jaws 16 asshown in FIG. 32 in an easy and repeatable manner. Cam feature 23 a, 23b are on an inner surface of the jaws 16 as shown and is between thefirst raised camming surface 212 and the second raised camming surface214.

Referring to FIG. 34, there is shown a view of the spindle 128 havingthe slider joint 202 and the driver bar 200 having the wedge plate 600removed for illustration purposes. The distal end of the driver bar 200has the driver camming surface 256. The driver camming surface 256cooperates and moves over the first and the second raised cammingsurfaces 212, 214 of the jaws 16 (FIG. 32) in response to the distalmovement of the driver bar 200 relative to the jaws 16.

Referring to a proximal end of the driver bar 200, the driver bar 200 isconnected to the slider joint 202. The slider joint 202 has a number oflatch retractors 158, 160 as shown in FIG. 34. Latch retractors 158, 160extend perpendicular therefrom and are configured to extend through thewindows 604, 604 in the wedge plate 600 shown in FIG. 33. These latchretractors 158, 160 limit a retraction and distal movement of the sliderjoint 202 relative to the jaws 16 as shown in FIG. 33. In one embodimentof the present clip applier 10, latch retractor 158 retracts while latchretractor 160 limits movement. Alternatively, latch retractor 160 mayretract while the latch retractor 158 limits movement. In anotherembodiment, each latch retractor 158 and 160 can switch betweenfunctions of limiting movement and retracting. In still anotherembodiment, more than two latch retractors 158, 160 may be provided.Various configurations are possible and within the scope of the presentdisclosure.

The operation of the surgical clip applier 10 to crimp a clip 300 arounda target tissue, such as a vessel, will now be described. Referring nowto FIG. 35 and FIG. 36, the trigger 18 is shown in an uncompressed statewith the driving member 36 in an original position, and biased by thespring 38.

Referring to FIG. 36A, there is shown the lockout mechanism 56 of thesurgical clip applier 10 with the lockout mechanism 56 in an originalinitial position. As shown in FIG. 36A, the arm 122 of the thirdrotatable member 120 has a portion that rests in a channel 121 of thehandle assembly 12 as shown in FIG. 36A. The third rotatable member 120mates with the lockout wheel 112 via post 118. In one embodiment, thethird rotatable member 120 is an indexer wheel.

Referring to an opposite view shown in FIG. 36B, the inner circumference114 of the lockout wheel 112 has a number of teeth 116 and the escapenotch 110. The escape notch 110 is disposed at a position around theinner circumference 114. The first rotatable member 102 having the arm104 and the pawl 106 is offset from the lockout wheel 112 and isdisposed so that the pawl 106 selectively engages with the teeth 116 asthe clip applier 10 is fired.

After the trigger 18 is fired the first rotatable member 102 will beradially advanced so that pawl 106 is urged to engage another tooth ofthe teeth 116. Referring to FIG. 36C through 36E, the lockout wheel 112has a predetermined number of teeth 116 complementary to the number ofclips in the clip carrying channel 302 such that when the last clip isfired, the pawl 106 will be aligned with the escape notch 110 allowingthe pawl 106 to enter escape notch 110 and be freed from the lockoutwheel 112. Referring now to FIGS. 36c and 36d , and FIGS. 36F through36I, the lockout mechanism 56 also has a ratcheting arrangement with aratchet arm 650 and a number of ratchet teeth 652. The ratchet arm 650of the third rotatable member 120 is designed to engage with ratchetteeth 652 and rotate the lockout wheel 112 clockwise in response toactuation of the trigger 18. Upon release of the trigger 18, the ratchetarm 650 thereafter is rotated in an opposite radial direction to moveover each of the ratchet teeth so as to allow the ratchet arm 650 tomove counterclockwise to reset to the original position after each clip300 is fired while not disturbing the radial advancement of the pawl106.

As best shown in FIGS. 37 through 42, and with reference to FIG. 38, inan unfired state the trip lever 500 is carried by the spindle 128. Thetrip lever 500 is biased by the trip lever spring 502. The trip lever500 also is in contact with the proximal window 410 in the feed bar 400.The trip block 406 is in a distal position relative to the trip lever500.

Referring now to FIG. 39, there is shown the follower 306 biased by thefollower spring 408 in order for the clips 300 to be biased in thedistal direction.

Referring now to FIG. 40, there is shown another cross sectional view ofthe spindle 128 having the cam link 208 and the wedge plate 600 restingon the spindle 128. The slider joint 202 is disposed under the wedgeplate 600 with the latch member 206 disposed in the slider joint 202.The spindle 128 drives the cam link 208 distally an initial distancesuch that the cam link boss 230 on the cam link 208 engages the cam slot612 in the wedge plate 600.

Referring to FIGS. 41 and 41A, there is shown another cross sectionalview of the outer tube 14 having the filler component 700. The wedgeplate 600 is disposed under the filler component 700 with the rotatablemember 702 extending therebetween.

The wedge plate 700 has the spring bar member 704 that is disposed inthe aperture 706. The spring bar member 704 biases the rotatable member702 and can deflect at its free end. The rotatable member 702 isdisposed distal relative to the camming feature 210 of the spindle 128that is beneath the filler component 700 shown in dotted lines. Oncedriven distally, the spindle 128 will advance. The spindle 128 willadvance the camming feature 210. The camming feature 210 will be drivendistally and will deflect the rotatable member 702 in a clockwisemanner.

Referring to FIG. 41B, there is shown a cross sectional view of thespindle 128 showing the various components therein along line 41B-41B ofFIG. 41. The clip 300 rests in the clip channel 302 and has the feed bar400 on a top side thereof. The wedge plate 600 is disposed underneaththe filler component 700 as shown and above the spindle 128. The clipchannel cover 310 is disposed above the clip channel 302.

The pusher 414 advances each of the clips 300 into the clip channel 24as shown in FIG. 42A. Spindle 128 shown in an unfired state in FIG. 42.The spindle 128 is disposed to connect to the slider joint 202. When theclip applier 10 is being fired, the spindle 128 moves distally. At apredetermined distance, latch member 206 is mechanically forced to camdown and engages channel 250 of the spindle 128 (which is best shown inFIG. 11) in the direction of reference arrow L shown in FIG. 73. Thisallows the slider joint 202 to move with the driver bar 200 (whendriven) distally. The driver bar 200 thus can engage the relevantsurfaces to close the jaws 16 around the clip 300 disposed in thechannel 24 between the jaws 16.

Referring now to FIG. 43, there is shown a perspective view of the wedgeplate 600 and the jaws 16 in an original proximal most position. Thewedge plate 600 has the wedge plate spring 602 in the window 604 aroundthe tongue 606. The wedge plate 600 further has a “C” shaped window 610to engage the rotatable member 702. The cam link 208 is in aproximal-most position relative to the cam slot 612.

Referring to FIGS. 44 through 46, the wedge plate 600 also has therounded distal end 616 engagable with the cam features 23 a, and 23 b toseparate the first jaw 16 a and the second jaw 16 b slightly as shownlater for loading.

Referring to FIG. 47, the cam link 208 is initially disposed in the camslot 612 in the initial proximal position with the filler component 700disposed below the cam link 208 in this view. Referring to the “C”shaped window 610 as shown on the proximal portion of the wedge plate600, the rotatable member 702 has the second end 710 extending throughthe “C” shaped window 610. The first end 708 of the rotatable member 702contacts the spring bar member 704 on the filler component 700 that isbeneath the wedge plate 600.

Referring to FIG. 48, to initiate actuation of the clip applier 10, thetrigger 18 is moved through an initial swing as shown by arrow C suchthat the wishbone link 26 drives the driving member as shown by arrow D.Referring to FIG. 49, the rack 40 on the driving member 36 begins toslide under the pawl 46 as shown by reference arrow E and the pawl 46rotates to deflect pawl return spring 48 by reference arrow F.

Referring now to FIG. 49A, the signaling device 54 is shown. Thesignaling device 54 also has an internal rib 2 that is integral with thehandle assembly 12. The click lever 78 contacts the click lever spring80 and upon being recoiled from the spring 80, the click lever 78 willhave the bulbous portion 190 of the click lever 78 contact the internalrib 2.

Upon contacting the internal rib 2, the bulbous portion 190 and theinternal rib 2 will resonate thereby providing the surgeon with theaudible indication of clip firing. Contemporaneously, as the drivingmember 36 and the rack 40 advance distally the pawl 46 rotates as shownin FIG. 50. If the trigger 18 were released at this point, the rack 40would restrain the pawl 46 against any proximal motion and thus preventrelease of the trigger and any partial or inadvertent partial actuationof the trigger 18.

Also, as shown in FIG. 50A, the lockout wheel 112 of the lockout device56 also rotates and has the pawl 106 contacting the teeth 116 on theinner circumference 114 of the lockout wheel 112. As shown, the pawl 106will advance from a first tooth space 3 to a next tooth space 5 onceclip 300 is fired. If another clip 300 is fired, the pawl 106 willrotate from space 5 to space 7 and continue to advance in acounterclockwise manner until the pawl 106 reaches the escape notch 110once the last clip 300 has been fired. The surgical clip applier 10 isloaded with a number of clips 300 that always exceeds a number of teethof the lockout wheel 112 to ensure that the surgical clip applier 10will never dry fire or in other words cannot fire without a clip 300.

Referring to FIG. 51, during the initial stroke, the spindle 128 moves apredetermined distance. As the spindle 128 moves a predetermineddistance distally, the trip lever 500 that this biased by the trip leverspring 502 moves distally and the feed bar 400 is driven distally by thetrip lever 500 engaging the feed bar window 410. Referring now to FIG.52, as a distal most clip 300 is moved into the channel 24 of the jaws16 by pusher 414, the follower 306 then moves in a distal direction andis urged forward by the follower spring 308. The follower 306 moves eachof the clips 300 in a distal manner to be loaded individually into thechannel 24 of jaws 16.

Referring now to FIGS. 53 through 55, there is shown a cross sectionalview of the various components of the clip applier 10 during the initialstroke with the filler component 700, wedge plate 600, and the cam link208. As the spindle 128 moves distally, the boss 230 on the cam link 208contacts the cam surface 614 on the cam slot 612 of the wedge plate 600as shown in FIG. 55. The cam link 208 moves distally with the spindle128 and the cam surface 614 is also urged distally relative to thefiller component 700.

Referring now to FIG. 56, the pusher 414 urges and advances anindividual clip 300 into the channel 24 of the jaws 16 while at anopposite end, the spindle 128 has a suitable geometry such that thespindle 128 has not contacted the driver bar 200 in order to actuate andclose the jaws 16.

Referring to FIG. 57, as the cam link 208 is advanced distally, the camlink 208 engages the cam surface 614 of the cam slot 612 to move thewedge plate 600 distally relative to the filler component 700.Contemporaneously, the “C” shaped window 610 also advances distally, anda lateral surface 625 contacts the second end 710 of the rotatablemember 702. The lateral surface 625 of the wedge plate urges therotatable member 702 to rotate counterclockwise as shown. The first end708 of the rotatable member 702 upon rotation contacts the spring barmember 704 on the filler component 700 and causes the spring bar member704 of the filler component 700 to deflect.

Referring to FIG. 58, the feed bar 400 continues to urge the pusher 414with the sloping surface to contact a single clip 300. The pusher 414continues to introduce the clip 300 into the clip channel 24. At thesame time, the wedge plate 600 continues to advance and be drivendistally by the cam link 208 urging the cam surface 614 of the cam slot612 as shown by the reference arrow.

FIG. 59 shows that the spring bar member 704 after being deflected bythe rotatable member 702 recoils in a direction of reference arrow G.The recoil moves the rotatable member 702 clockwise so the second end710 contacts a lateral side 626 of the “C” shaped window 610 as shown byreference arrow H. The rotatable member 702 thus conveniently holds thewedge plate 600 in a most distal position and completely controls aposition of the wedge plate 600 for loading.

The cam link 208 at this most distal position of FIG. 59 contacts thecamming feature or the disengaging cam surface 726 of the fillercomponent cam slot 720 on the filler component 700. The cam link 208 isnow cammed out of engagement with the cam surface 614 and the wedgeplate 600 is at its most distal position, and the cam link 208 no longerdrives the wedge plate 600 distally.

Referring to FIGS. 60 and 61, the rounded distal end 616 of the wedgeplate 600 is now moved in between the camming surface 23 a, 23 b of thefirst and the second jaw components 16 a, 16 b as shown. The roundeddistal edge 616 of the wedge plate 600 thus moves the first and secondjaw components 16 a, 16 b opposite from one another as shown for gentlyincreasing a size of the channel 24. This additionally restrains each ofthe jaw members 16 a, 16 b from flexing with regard to one anotherpreventing any torque on the clip 300 as it is being inserted betweenthe jaws 16 as shown by the reference arrows.

As best show in FIG. 62, the cam link 208 continued to advance distallyin the cam slot 612 while the wedge plate 600 is held by the rotatablemember 702 at the second end 710. Rotatable member 702 is held by thespring bar member 704 at the second end 710 between the spring barmember 704 and a lateral wall of the aperture 706 of the fillercomponent 700. Referring to FIG. 63, the spindle 128 continues to movedistally through the stroke, and the trip lever 500 is urged distallywith the spindle 128.

At the proximal end of the feed bar 400, the camming surface of the feedbar 400 and the trip lever 500 are cammed out of engagement relative toone another. The trip lever 500 is cammed out of engagement relative tothe window 410 of the feed bar 400 by the toothed member 420 of the tripblock 406. This allows the feed bar 400 to return to a proximal initialposition due to the biasing of the feed bar 400. Thus, the loading ofthe clip 300 into the channel 24 is complete and the feed bar 400 isretracted back to an initial position by spring tension.

Referring to FIG. 64, the distal portion of the feed bar 400 is showncompleting the loading of the clip 300, and thereafter retracts to aninitial proximal location of the clip applier 10.

As best shown in FIGS. 65 and 65A, there is shown a bottom view of thewedge plate 600 (FIG. 65), and a top view the filler component 700 (FIG.65A), and the spindle 128 shown in dotted lines. The spindle 128 has thecamming feature 210 or edge that contacts the second end 710 of therotatable member 702 as the spindle 128 advances distally. As shown fromthe opposite view, the camming feature 210 is advanced distally anddeflects the rotatable member 702 in a counterclockwise manner. Therotation causes the first end 708 of the rotatable member 702 tolikewise deflect the spring bar member 704 of the filler component 700.Notably, the rotatable member 702 is no longer holding the wedge plate600 and the wedge plate 600 is permitted to retract by spring torsion.

Referring now to FIG. 66, as being moved distally by the spindle 128,the trip lever 500 is cammed out of engagement with the feed bar window410. This permits the feed bar 400 to retract in a proximal direction asshown by arrow J. The spindle 128 continues to advance distally duringthe stroke.

Referring to FIG. 67, there is shown the clip 300 inserted into thechannel 24 between the jaws 16. As best shown in FIG. 67, the feed bar400 now retracts after reaching a most distal position to the next clip300 and the loading is completed. The trip lever 500 is cammed out ofengagement with the feed bar 400 and this allows the pusher 414 toretract proximally. As shown in FIG. 67, the feed bar 400 retracts sothe nose of the pusher 414 aligns to an initial position for loading thenext clip 300 of the number of clips into the channel 24.

Referring now to FIG. 67A, there is shown a cross sectional view of thehandle assembly 12. The trigger 18 is being fired by the surgeon andtypically is grasped and pulled in a direction of reference arrow A. Thetrigger 18 moves the wishbone link 26 that advances to the end of thelongitudinal window 60 of the actuator plate 50. The actuator plate 50driven distally moves the protrusion 70 link to the LCD lever 52 thatcontacts a suitable LCD contact 100 on the LCD unit 96 to change thedisplay on the LCD display 98 and/or change the displayed parameter. Thewishbone link 26 also drives the driver member 36 distally to advancethe spindle 128.

The signaling device 54 is also driven by the actuator plate 50 and hasthe click lever 78 commencing to rotate to contact the rib 2 of thehandle assembly 12.

Referring now to FIG. 68, as the stroke progresses, the spindle 128 andthe trip lever 500 continue to move distally, and the trip lever 500 iscompletely cammed down to be underneath the trip block 406 so the feedbar 400 is disengaged from the trip lever 500 and the feed bar canretract proximally behind the nest most distal clip in the clip channel302.

Referring to FIG. 69, there is shown a top view of the wedge plate 600.As discussed previously, the spindle 128 continues to moves the cam link208 distally through the cam slot 612. Referring to the “C” shapedwindow 610 of the wedge plate 600 and the filler component 700 shownabove the wedge plate 600, there is shown the rotatable member 702. Therotatable member 702 has a first proximal end 708 and an opposite seconddistal end 710. The second distal end 710 of the rotatable member 702snaps back into the more distal region of the “C” shaped window 610. Thespring bar member 704 deflects and returns to an original position.

Referring to FIG. 70, the rounded distal end 616 of the wedge plate 600is retracted from the jaws 16 after loading and moves in a proximalposition. As shown in FIG. 70, the clip 300 rests in the channel 24 ofthe jaws for application of a compressive force by the jaws.

Referring to FIG. 71A, the actuator plate 50 in the handle portion 12continues to move distally urging audible click lever 78 to rotatecounterclockwise. The audible click lever 78 is then deflected by theclick spring 80. Referring to FIG. 71, the latch member 206 is cammed ina direction toward the spindle 128 so the driver bar 200 can now beengaged and move distally to apply the required compressive force. Thedriver bar 200 is engaged by the spindle 128. The driver bar 200 isdriven distally to force jaw legs 16 a and 16 b toward one another so asto compress clip 300 on a vessel.

Referring to FIG. 72, there is shown a cross sectional view of thehandle assembly 12 during a full stroke. The pawl 46 resets itself sothat the instrument can retract and reset when the trigger 18 isreleased. The rack 40 on the driving member 36 is cleared from the pawlin the full stroke position.

Notably, the audible click lever 78 contacts the rib 2 of the housing ofthe handle 12 by having the bulbous portion 190 sharply contacting therib 2 making a loud and audible clicking sound. The audible click lever78 is rotated by the actuator plate 50 that is moved distally by thedriving member 36.

Referring to FIG. 73, there is shown the cross sectional view of theendoscopic portion at the full stroke. A full stroke of the spindle 128is required to take a clip 300 from an initial position to a fullyinserted position in the jaws 16. The spindle 128 driven to a distalmost position moves the driver bar 200 to crimp the clip.

FIGS. 74 through 76 show the driver bar 200 having the camming surfaces256 that engage other the first and the second raised camming surfaces214, 216 being on each of the jaws 16 a, 16 b. The driver bar 200 ridesthe raised surfaces to close the jaws 16 with the clip 300 in thechannel 24. As shown in cross section along line 76-76 of FIG. 75, FIG.76 shows the driver bar 200 with a “T” shaped channel that closes overthe camming raised surfaces 212, 214 of the jaws 16 to apply acompression on the clip 300 in the channel 24.

Referring to FIG. 77, the clip applier 10 has a security mechanism beingprovided to prevent an over stroke or excessive compression of the clip300 in the channel 24 by the jaws 16 by squeezing. Such an excessivecompression may cause one or more detriments such as an excessivecompression of the clip 30 or damage to the driver bar 200, or the jaws16. If the trigger 18 is continued to be squeezed past a full strokerequired for a full forming of a clip 300 as shown in FIG. 78, theimpact spring 196 of FIG. 77 compresses in the spaced defined by theknob 20 and the bushing 156. The impact spring 196 prevents any furtherdistal movement of the spindle 128 by absorbing force beyond what isrequired to close a clip on a vessel.

Once the trigger 18 is released as shown in FIG. 79, the pawl 46 rotatesagainst the bias of the pawl return spring 48 so the pawl tooth 178 ridealong the rack 40 to reset the handle assembly 14 as shown by thereference arrow K. The drive member 36 retracts to reset. The rack 40 onthe drive member 36 moves proximally and back under the pawl 46.

Referring to FIG. 80, the spindle 128 retracts to a proximal positionand the latch member 206 is driven upwards opposite the spindle 128.Referring to FIGS. 81 through 86, the spindle 128 having the cammingfeature 210 retracts proximally and contacts the rotatable member 702that rotates first proximal end 708 of the rotatable member 702 tocontact the spring bar member 704 of the filler component 700.

Referring to FIG. 82, as the spindle 128 retracts in a proximalposition, the cam link 208 moves again through the cam slot 612 in thewedge plate 600. The spindle 128 continued to retract proximally and thecam link 208 as shown in FIGS. 82 and 83 is drawn proximally and resetsand is cammed to an original position.

It should be understood that the wedge plate 600 does not retract as ithas fully retracted already, and the proximal movement by the spindle128 causes the cam link 208 to return to its original position. In thisposition, the clip applier 10 is again in an initial position to bere-fired and this to attach to another clip 300 to a vessel.

Referring now to FIG. 84 through 86, the first rotatable member 102 willcontinue to ratchet through the teeth 116 of the lockout wheel 112. Thelockout wheel 112 will progress and radially advance after each of theclips 300 is fired. As shown in FIG. 85, the first rotatable member 102will rotate until the pawl 106 will reach the escape notch 110 in thelockout wheel 112. The escape notch 110 will then allow the pawl 106 totraverse out from the lockout wheel 112 as shown by arrow K in FIG. 85.

Referring to FIG. 86, the pawl 106 will then mate with a correspondingnotch (A) shown in the trigger handle 18. Upon the pawl 106 mating inthe notch A, the clip applier 10 will be locked and the pawl 106 willprevent any further firing or driving of the driving member 36 by thetrigger 18. Thereafter, the clip applier 10 may be disposed in asuitable receptacle. Most preferably, the clip applier 10 is loaded witha number of clips 300 that exceed the number of teeth in the lockoutwheel 112. To this end, the clip applier 10 cannot be dry fired withouta clip therein.

Referring now to FIGS. 87 through 89, there is shown an alternativeembodiment of a number of components of the present clip applier 10.Referring to FIG. 87, there is shown an exploded view of a wedge plate750, a link cam 752, a filler component 754, and a spindle 756.

The wedge plate 750 is similar to the embodiment shown previously andhas a rounded distal end 758 and is suitably biased at the proximal endto the filler component 754. The rounded distal end 758 preferably movesin a distal manner as discussed to be disposed between the jaws 16 ofthe clip applier 10 for clip loading. The wedge plate 750 further has alink cam notch 760. The link cam notch 760 is in a substantially amid-portion of the wedge plate 750. The link cam notch 760 is generallyorthogonal shaped and is shaped into a lateral side of the wedge plate750. The link cam notch 760 has a depth that is suitable to extend aboutto a middle of the wedge plate 750. Alternatively, the link cam notch760 may have another shape or be circular or curved. Variousconfigurations are possible and within the scope of the presentdisclosure. The link cam notch 760 preferably allows for the link cam752 to engage and move the wedge plate 750 distally. The distal movementintroduces the rounded distal end 758 between the jaws 16. Distalmovement of the spindle 756 disengages the wedge plate 750 at apredetermined line of demarcation.

The filler component 754 being shown above the wedge plate 750 in FIG.87 does not move relative to the other components and is intended toremain stationary. The filler component 754 has a link cam aperture 762.The link cam aperture 762 is a circular shaped feature that is disposedin the filler component 754 to allow the link cam 752 access. The linkcam aperture 762 is in a complementary location relative to the link camnotch 760 of the wedge plate 750. The location allows a portion of thelink cam 752 to engage the link cam notch 760.

The link cam 752 preferably has two discrete portions. The link cam 752has a first base 764 and a second arm 766. The first base 764 rests andis rotatably mounted in the link cam aperture 762 of the fillercomponent 754. The second arm 766 is connected to the first base 764.The second arm 766 is engagable with the link cam notch 760 of the wedgeplate 750. The second arm 766 also has a post 767 that rides in a camslot 768 of the spindle 756. The link cam 752 preferably has a portionthat rotates to move another member a certain fixed distance, and thenat the conclusion of the movement to return the member to its initialposition.

Referring now to the spindle 756, the spindle 756 is shown disposedbelow both the filler component 754 and the wedge plate 750 in FIG. 87and has a cam slot 768. As can be understood, referring now to the camslot 768 from a distal starting location 770 along the cam slot 768 to aproximal ending location 772, it is understood that the post 767 of thesecond arm 766 of the link cam 752 rides in the cam slot 768 and followsthe precise path of the cam slot 768 as the spindle 756 advancesdistally through the stroke. The post 767 drives the wedge plate 750 inthe cam slot 768 until a certain line of demarcation is reached, then aspring (not shown) or another biasing device of the link cam 752retracts the post 767.

Referring now to FIG. 88A, there is shown the filler component 754resting on the wedge plate 750 in an assembled state. As can beunderstood from the figures, the link cam aperture 762 is shown with thefirst base portion 764 being in the link cam aperture 762 of the fillercomponent 754. One skilled in the art should appreciate that the firstbase portion 764 can freely move or freely rotate in the link camaperture 762 of the filler component 754. One skilled in the art shouldfurther appreciate that the first base portion 764 of the link cam 752can rotate the second arm portion (not shown) underneath the fillercomponent 754 with any desired degree range of rotation and withaccuracy, and the clip applier 10 is not specifically limited to anyspecific amount of rotation.

Referring now to FIG. 88B, there is shown a view of the wedge plate 750resting on the spindle 756 with the filler component 754 of FIG. 88Abeing removed simply for illustration purposes only. As can be now seenwith the filler component 754 of FIG. 88A removed, the link cam 752 hasthe second arm 766 with the post (not shown) engaged to the link camnotch 760 of the wedge plate 750. In this manner, as the second arm 766of the link cam 752 rotates, the post 767 will urge the wedge plate 750distally and notably will urge the rounded distal end 758 shown on thedistal side between the jaws 16 for loading the clip.

Referring now to FIG. 88C, there is shown the cam slot 768 of thespindle 756 in broken lines being beneath the wedge plate 750. In thedistal most starting location 772 of the cam slot 768, the cam slot 768will not disturb an orientation of the link cam 752. However, as thepost 767 of the second arm 766 contacts cam feature 774 of the cam slot768 shown in broken lines, the second arm 766 will be cammedcounterclockwise, and thus drive the wedge plate 750 by engaging andpushing the link cam notch 760 distally. As the spindle 756 is continuedto be driven distally through the stroke, the post 767 of the second arm766 of the link cam 752 will traverse past the cam feature 774. Notably,at this location, the rounded distal end of the wedge plate 758 will bebetween the jaws 16 for loading.

Referring now to FIG. 89, there is shown a close up view of the link cam754 along window 92 of FIG. 88C in the cam slot 768 of the spindle 756.As the link cam 754 is driven distally past the camming feature 774 ofthe spindle 756, the link cam 754 will be driven into the proximal mostlocation 770 of the cam slot 768. This proximal most location 770 of thecam slot 768 will permit retraction of the wedge plate 750 once the jaws16 have been loaded and as the spindle 756 is continued to advancethrough the stroke for firing.

Referring now to FIG. 90, there is shown another alternative embodimentof the present clip applier 10. The clip applier 10 in this embodimenthas the signaling device 54. The signaling device 54 as discussedpreviously provides an indication to the surgeon that a surgical eventhas occurred, is occurring or will occur in the future.

The surgical event may be any event associated with the clip applier 10,related to the surgical procedure, or both. In one embodiment, thesurgical event may be related to the number of available surgical clipsremaining in the clip applier 10. In another embodiment, the surgicalevent may be related to an indication of a time as to when the clip 300is recommended to be fired. In another embodiment, the surgical eventmay be related to or preventing any dry firing of the clip applier andthe signaling device 54 may alert the surgeon that the number ofsurgical clips 300 in the clip applier 10 are too low and that a newclip applier 10 or another device should be procured. In anotherembodiment, the surgical event may be other important or convenientparameters of the surgery such as a total time of surgery. Variousconfigurations are possible and within the scope of the presentdisclosure, and the signaling device 54 preferably assist the surgeonwith feedback of parameters that cannot be readily seen, especially intandem with using other endoscopic instruments.

Referring now to FIG. 90, there is shown a first component 776 of thesignaling device 54. The first component 776 is a cylindrical shapedmember. The first component 776 preferably has a proximal opening 778.The proximal opening 778 has a channel 780. The channel 780 also hasfirst and second lateral sub channels 780 a, and 780 b that extend intothe lateral sides of the first component 776. The proximal opening 778also has an interior lateral surface 780 c that is disposed to surroundan interior of the channel 780.

The first component 776 also has a distal side 782 having a cammingfeature 784. In this embodiment, the distal side 782 has the cammingfeature 784 being a first and a second pointed ends 786, 788. Referringnow to FIG. 91, there is shown a top view of the first component 776. Ascan be understood from the drawings, the first and the second pointedends 786 and 788 (the first end being obstructed by the side view of thedrawing shown in FIG. 90) protrude outward and away from the firstcomponent 776 at the distal side 782. The first component 776 also has ashelf 787. Referring now to FIG. 92, there is shown a top view of thefirst component 776. The first component 776 (in this view) has thefirst and the second pointed ends 786, 788 extending outwardly from thedistal side 782.

Referring now to FIG. 93, there is shown a view of the proximal opening778 and channel 780. As can be understood the channel 780 is suitablysized to permit another member access therein. The channel 780 also hasthe lateral sides with the first lateral sub channel 780 a and thesecond lateral sub channel 780 b.

Referring now to FIG. 94, there is shown a second component 790 of thesignaling device 54. The second component 790 is a lever type structureand is capable of rotation about one rotational axis shown as referenceA for illustration purposes. The second component 790 has a main post792. The main post 792 sits on a base portion 794 has a camming surface796, and is for insertion in the first component 776. Preferably, thecamming surface 796 has a suitable size to receive one of the first andthe second pointed ends 786 and 788. Notably, the second component 790rotates.

The second component 790 also has another second post 902 and a thirdpost 904. The second post 902 is connected to the main post 792 by alinkage 906 and the third post 904 is connected to the main post 792 byanother second linkage 908. Preferably, the main post 792 extends intothe channel 780 of the first component 776 and the first pointed end 786engages with a first sub recess 910 of the camming surface 796. Uponrotation, the first pointed end 786 of the first component 776 will ridein the cam surface 796 causing the first component 776 to move away fromthe second component 790. The first pointed end 786 will advantageouslytraverse from the first sub recess 910 to an adjacent second sub recess912 when the first component 776 is rotated causing the first component776 to move away from the second component 790 in a direction parallelto the longitudinal axis A.

Referring now to an interior view of the handle portion 12 of the clipapplier 10 shown as FIG. 95, there is shown a rib portion 914 thatextends inwardly and into the handle portion 12. The rib portion 914 isa cylindrical shaped feature. The rib portion 914 is preferably moldedinto the handle portion 12. The rib portion 914 has a lateral strip 916.The lateral strip 916 is an orthogonal shaped member that is integrallyconnected with the cylindrical shaped rib portion 914.

FIG. 96 shows an interior view of an opposite lateral side of the handleportion 12 of the clip applier 10 that mates with a portion of thehandle portion 12 shown in FIG. 95. FIG. 95 shows a partially assembledview of the signaling device 54 of the clip applier 10 having a spring901 that rests on the shelf 787 of the first component 776. As can beunderstood from FIG. 95, the lateral strip 916 of the rib portion 916(shown in FIG. 95) engages and is disposed through the first cylindricalportion 776. The lateral strip 916 prevents the first component 776 fromrotating. As the first component 776 attempts to rotate relative to thefixed lateral strip 916 of the rib portion 914 (shown in FIG. 95), thelateral strip 916 contacts and prevents the first component from movingdue to contact with a lateral side of the first lateral sub channel 780a.

Referring still to FIG. 95, the driver bar 918 is connected to actuatorplate 920. The actuator plate 920 in this embodiment has a notch 922 ona proximal side thereof. The notch 922 engages the second post 902 ofthe second component 790. As the driver bar 918 is driven distally, thedriver bar 918 will also urge the actuator plate 920 distally in alikewise manner. The actuator plate 920 having the notch 922 will alsorotate the second post 902 of the second component 790 (shown in FIG.94). The second component 790 will likewise rotate in a counterclockwise manner thereby rotating the cam notch 796 (shown in FIG. 94).The cam notch 796 (shown in FIG. 94) will also rotate and attempt torotate the first pointed end 786 (shown in FIG. 92) of the firstcomponent 776. However, the lateral strip 916 (shown in FIG. 95)prevents such rotation. This causes the first component 776 to traverseaway from the second component 790 with the spring 901 biasing the firstcomponent 776 in a direction inward toward the second component 790. Thecam notch 796 will then cause the first component 776 to separate fromthe second component 790 and ride up the cam notch 796. As the firstcomponent 776 traverses in the cam notch 796, the first component 776will then return and sharply contact the second component 790 due to thebiasing of the spring 901. This sharp contact between the firstcomponent 776 and the second component 790 causes an audible click ofthe surgical event such as a clip being fired. This indication providesfeedback to the surgeon that the clip has been fired. Variousconfiguration are possible and within the scope of the presentdisclosure. FIG. 97 illustrates a clip 300 applied to a vessel.

In another embodiment of the present disclosure, the clip applier 1010includes a lockout device. The lockout device is located in the handleportion 12 of the instrument 1010, and locks operation of one or moresubassemblies of the instrument 1010. The lockout device is configuredto prevent activation of the instrument irrespective of the forceapplied to the trigger 14. The lockout device in this embodimentprevents the spindle 128 from moving longitudinally. Thus, the driverbar 200 (or other subcomponents thereof) cannot crimp a clip between thejaws 16 a, 16 b when there are no remaining clips 300 in the clipapplier 10.

More particularly, after a predetermined number of clips 300 have beenfired from the clip applier 1010, the clip applier 1010 willautomatically lock to prevent further deployment of clips. In thismanner, the lockout provides a tactile feedback to the surgeon thatthere are no remaining clips 300 to be applied to tissue since there areno clips 300 remaining in the clip applier 1010. Referring to FIG. 98, anumber of components of the lockout device will be shown and described.FIG. 98 illustrates that the clip applier 1010 has a spring 1100 that isdisposed in a predetermined location of a clip carrying channel 1102(FIG. 99). Although shown as being associated with the clip carryingchannel 1102, the spring 1100 may be disposed in other areas of the clipapplier 1010, such as in a magazine, or with an embodiment where theclip applier 1010 does not include a clip carrying channel 1102, thespring 1100 may be disposed or located in other areas. The spring 1100has a first cantilevered free end 1108 and an opposite end 1104. End1104 is adapted to receive a lockout bar 1106 (See FIGS. 101 and 102).The clip carrying channel 1102 is reproduced in FIG. 102 and FIG. 100 ina top view. As can be understood, the distal side 1112 (FIG. 100) of thechannel 1102 has the aperture 1110.

Referring to FIGS. 101 and 102, the clip applier 1010 also has a lockoutbar 1106. The lockout bar 1106 is reproduced in FIG. 101 in a top view.The lockout bar 1106 includes a first end 1114, and a second oppositehook end 1116. The lockout bar 1106 is sufficiently sized so as to bewedged between a ceiling and a floor of the clip carrying channel 1102.In another embodiment, the bar may be wedged between a ceiling and afloor of a clip magazine. The groove in the second hook end 1116 isadapted to engage a clip follower 1118 (FIG. 112) of the clip applier1010. However, the lockout bar 1106 may be removably or permanentlyconnected to the clip follower 1118 by other methods such as a snap-fitarrangement, a friction-fit arrangement, a screw-fit arrangement, a pinarrangement, or any other arrangement such that first end 1114 may move.The lockout bar 1106 is retained between the bottom of the channel coverand the floor 1102′ of the clip carrying channel 1102. The lockout bar1106 rests in a distal slot 1117 formed in the clip follower 1118 (asshown in FIG. 112). The slot 1117 is shown as generally orthogonal, butmay have any similar or different shape known in the art to permit thecomponents to rest in the clip follower 1118. The lockout bar 1106 doesnot by itself lockout the clip applier 1010, but instead merely movesupwardly through the clip carrying channel 1102 when there are little orno remaining clips 300 in the clip carrying channel 1102.

FIG. 103 illustrates a partially assembled view of the lockout spring1100 with the lockout bar 1106. Referring to FIGS. 103 and 106, clipfollower 1118 biases a stack of clips 300 in a clip carrying channel1102 in a distal manner so the clips 300 may be available to be loadedbetween the jaws 1016 a, 10166 b in order to be applied to tissue asshown in FIG. 97. The clip follower 1118 has a distal slot 1117 (FIG.104). The lockout bar 1106 is adapted to be received in the slot 1117and move distally with the clip follower 1118 each time the clip applierinstrument 1010 is fired, and the clip follower 1118 is advanceddistally.

FIG. 105 shows that the clip applier 1010 has a feed bar 1120. The feedbar 1120 reciprocates distally, then proximally during each stroke ofthe firing trigger to load a single clip 300 between the jaws 1016 a,1016 b (FIG. 108) of the clip applier 1010. The feed bar 1120 has adistal window 1122. The feed bar 1120 is made from a thin metallicmaterial and is moved distally by a trip lever (not shown) and triplever spring (not shown) as previously discussed with regard to theembodiment above. The feed bar 1120 is advantageously disposed above theclip follower 1118 (shown in FIG. 107) and the clip carrying channel1102 (shown in FIG. 109). The proximal end of the feed bar 1120 has apair of fins 1119 (FIG. 105). The fins 1119 engage a proximal window1134 of a spindle 1132 of the clip applier 1010 (FIG. 114). In anotherembodiment, the proximal end of the feed bar 1120 may have a single fin,or a member which engages window 1134 (or a particular) slot of thespindle 1132.

Referring now to FIG. 106, each time a clip 300 is fired from theinstrument 1010 the clip follower 1118 will advance distally relative tothe clip carrying channel 1102. FIG. 107 shows a side view of thecomponents of the clip applier 10 with the clip follower 1118 in itsdistal most position, and the cover of the clip applier 1010 removed forillustration purposes. The feed bar 1120 includes a distal nose 1128which advances the clips between the jaws (not shown). The feed bar 1120also has a distal window 1122. The clip follower 1118 is positionedbeneath the feed bar 1120 and has a slot 1117. The lockout bar 1106 ispositioned in the slot 1117 of the clip follower 1118. As shown in FIG.107, in the distal most position, the lockout bar 1106 will deflectupward and engage window 1122 of the feed bar 1120.

FIG. 108 shows a top perspective view of the components of the clipapplier 1010. The clip applier 1010 has a first jaw 1016 a, a second jaw1016 b, a stop 1018 connected to a cover 1020, and a feed bar 1120. Feedbar 1120 has the distal window 1122. The lockout bar 1106 extends intothe distal window 1122 when the follower 1118 is in its distal mostposition, i.e., when there are no remaining clips. In anotherembodiment, the lockout bar 1106 extends into the distal window 1122when the follower 1118 is in its partially distal most position, i.e.,when there are little remaining clips such as one, two, or threeremaining clips. Various arrangements and position of the window 1122are possible and within the scope of the present disclosure, and itshould be appreciated that the window 1122 can be placed at variedlocations to lockout the clip applier 1010 with any number of remainingclips in the clip applier 1010.

FIG. 109 shows a top perspective view of the components of the clipapplier 1010 with the cover 1020 of FIG. 108 removed and showing thenose 1128 of the feed bar 1120. As shown, the clip follower 1118 is inthe clip carrying channel 1102 and will advance clips in a distaldirection until it reaches its distal most position as shown. As can beseen from FIG. 109, the clip follower 1118 is in the distal mostposition (as an example for illustration purposes) when there are noremaining clips in the clip carrying channel 1102 or available to befired by the clip applier 1010. The feed bar 1120 having the distalwindow 1122 in this distal most position aligns with the lockout bar1106. The lockout bar 1106 in this distal most position will bedeflected upwardly and extend though the distal window 1122.

FIG. 110 shows a top perspective view of the components of the clipapplier 1010 with the cover 1020 and the feed bar 1120 both removed forillustration purposes to show the relationship between the lockout bar1106 and the clip follower 1118. As seen in FIG. 110, the clip carryingchannel 1102 has a number of fingers 1103″ on the lateral sides of theclip carrying channel 1102 to maintain the clips (not shown) aligned inthe clip carrying channel 1102. Clip follower 1118 is positioned in theclip carrying channel 1102. The lockout bar 1106 is shown positioned inthe slot 1117. It should be appreciated the lockout bar 1106 and theslot 1117 may have different shapes and geometries, and the presentdisclosure is not limited to any particular shape or geometry. It shouldfurther be appreciated the follower 1118 and the lockout bar 1106 may beformed as an integral member with one another. Various configurationsare possible and within the scope of the present disclosure.

Referring to FIG. 111, there is shown a bottom view of the clip follower1118. In this view, the clip follower 1118 is shown as having the slot1117 being generally orthogonal shaped and disposed along a longitudinalaxis A of the clip follower 1118. As can be seen from FIG. 111, beneaththe lockout bar (not shown) is the lockout spring 1100, and the spring1100 biases the bar 1106. The lockout spring 1100 has a bulbous member1108′ at end 1108. The bulbous member 1108′ of spring 1100 is largeenough so as to pass over and avoid being caught in the aperture 1110 inthe clip carrying channel 1102 (shown in FIG. 100).

Once the member 1108′ of spring 1100 reaches a predetermined point onthe clip carrying channel floor 1102′ or a location where member 1108′is located past aperture 1110 in FIG. 100, the hook portion 1116 of thelockout bar 1106 will fit into and engage aperture 1110.

Referring to FIG. 112, there is shown a cross sectional view of the clipfollower 1118 having the lockout bar 1106 positioned in the slot 1117 ofthe clip follower 1118. The view is taken along section line 16-16 ofFIG. 111. Slot 1117 of the clip follower 1118 has a pin 1117 a that isdisposed in the groove on the hook portion 1116 of the lockout bar 1106.Pin 1117 a prevents the lockout bar 1106 from being separated from theclip follower 1118 during distal movement.

Disposed underneath the lockout bar 1106 is the lockout spring 1100 thatbiases the lockout bar 1106 in a direction opposite the clip carryingchannel 1102 as shown in FIG. 111. Prior to the last clip being applied,the lockout bar 1106 is retained between the bottom surface of thechannel cover and the floor 1102′ of the clip carrying channel 1102.

FIG. 107 illustrates that at the distal most position of the clipfollower 1118, the lockout spring 1100 will move and rotate the free end1114 of the lockout bar 1106 to a position extending above the clipcarrying channel 1102. Thus, the free end 1114 of the lockout bar 1106will rotate upward and escape through the ceiling 1103′ of the clipcarrying channel 1102 at the distal position of the clip follower 1118to engage the distal most window 1122 of the feed bar 1120 as shown inFIG. 107. The hook portion 1116 of the lockout bar 1106 will rotate downand engage aperture 1110 in the floor of the clip carrying channel 1102.

The distal window 1122 of the feed bar 1120 is shown above immediatelyadjacent to the nose 1128 of the feed bar 1120 (FIG. 113). The free end1114 of the lockout bar 1106 of FIG. 107 will move above and through theclip carrying channel 1102 and will engage the distal window 1122 of thefeed bar 1120 as shown in FIG. 107.

A spindle 1132 is shown in FIGS. 114 and 115. On a proximal side, thewindow 1134 is suitably sized and positioned such that the fins 1119 ofthe feed bar 1120 (shown in FIG. 105) simply rest in the window 1134 ofthe spindle 1132 during normal operation of the clip applier 1010without effecting the distal or proximal movement of the spindle 1132.The window 1134 is shown in an enlarged view in FIG. 116.

As shown in FIG. 116, the window 1134 has a generally orthogonal shapeand the outer lateral surface of the window 1134 will not interfere orcontact other components during the normal operation of the clip applier1010. The feed bar 1120 (shown in FIG. 105) is a thin member relative tothe spindle 1132 of FIG. 116. In one embodiment, the feed bar 1120 is athin metallic member. In another, the feed bar 1120 is a thinthermoplastic member. The feed bar 1120 is suitable for reciprocationdistally and proximally relative to the spindle 1132. When the fins 1119hook the distal edge of window 1134 of spindle 1132, the feed bar 1120prevents retraction but not advancement of the spindle 1132.

However, given that the spindle 1132 cannot retract fully proximally,the pawl 1146 in the handle portion (FIG. 117) cannot return to the homeor initial position relative to the rack 1140 in the handle portion 12of the clip applier 1010. Instead, as shown in FIG. 118, the pawl 1146will remain in an intermediate position relative to the rack 1140. Whenthe trigger (not shown) is squeezed, pawl 1146 cannot rotate enough tobe free of the rack 1140 or move clockwise to reset the pawl 1146 to thehome (or at rest position for the next firing of the instrument as shownin FIG. 117). Thus, the pawl 1146 and rack 1136 lockout the trigger 14from being squeezed and the spindle 1132 cannot move distally to engagethe driver bar (FIGS. 26 and 27) and subsequently the clip applier 1010is unable to close the jaws 1016 a, 1016 b. The surgeon will feel astrong tactile feedback from the trigger 14 and resistance that thetrigger 14 cannot be compressed toward the handle 12 any further, thussignaling that the clip applier 1010 needs to be disposed/replaced witha new instrument.

Turning now to FIG. 119, there is shown a perspective view of a shearpin 1148 for a secondary lockout mechanism 1150. The shear pin 1148 is agenerally cylindrical member having a three-part body 1152 defining afirst neck portion 1154 and a second neck portion 1156. The first neckportion and the second neck portion 1154, 1156 respectively have a widththat is less than a width of the body 1152 and are configured to engagea linkage 1160. More particularly, trigger 1156 is connected to linkage1160, which, in turn, engages the first and the second neck portions1154 and 1156 of pin 1148.

Referring now to FIG. 120, there is shown a side cross sectional view ofthe clip applier 1010 having the rack 1140 and pawl 1146 locking out thespindle 1132 as described above with the secondary lockout mechanism1150. As shown, the trigger 1156 will be prevented from advancing thespindle 1132 distally since the rack 1140 and the pawl 1146 prevent thespindle 1132 from retracting proximally as discussed above. However, inthis embodiment, the instrument 1010 has a secondary lockout 1150 toprevent the surgeon from placing too much force on the trigger 1156 andthe handle 1158 which could possibly overcome or dislodge the engagementbetween the rack 1140 and the pawl 1146, and move the spindle 1132distally.

Turning now to FIG. 121, if a force F1 is placed on the trigger 1156,the trigger 1156 will move toward the handle 1158 to advance the link1160. The link 1160 will advance the shear pin 1148 distally to advancethe spindle 1132 distally by spindle link 1132 a. The engagement betweenthe pawl 1146 and the rack 1140 will prevent the spindle 1132 frommoving distally as discussed above. However, now turning to FIG. 122, ifa force F2 (that is greater than the force F1) is applied to the trigger1156 to further compress the trigger 1156 which could potentiallydislodge the engagement between the rack 1140 and the pawl 1146, theforce F2 will break shear pin 1148. Thus, the connection between thetrigger 1156 and the spindle 1132 is broken and the link 1160 cannotadvance the spindle link 1132 a distally. Thus, a secondary lockout isachieved.

With reference to FIGS. 123-126, it is contemplated that the clipapplier 10 may include a ratchet assembly having an override feature ordevice, generally identified by reference numeral 800. Ratchet assembly800 enables or permits the clinician to open the jaws 16 (FIG. 1) at anypoint during the firing of a surgical clip. As noted above, duringoperation, the teeth 44 of the rack 40 and the pawl 46 prevent therelease of the trigger 18 (FIG. 1) before a full actuation thereof.Therefore, if the clinician should wish to abort the firing of a clip,not fully form a clip (e.g., in a case where the clip is being formedover a catheter or other similar device to retain the catheter, ratherthan clamp the catheter to close it off), or if an obstruction is placedbetween the jaws 16 that inhibits full formation of a clip, theclinician is inhibited from opening the jaws 16 or returning the trigger18 to a fully unactuated position. Effectively, the clip applier 10 islocked against further use.

The ratchet assembly 800, having an override feature, includes a pawl846 that is substantially similar to pawl 46, and therefore, forpurposes of brevity only the differences therebetween will be describedin detail hereinbelow. In order to permit the clinician to open the jaws16 and allow the trigger 18 to be returned to an unactuated position(prior to a complete actuation thereof), it is contemplated that thepawl 846 may define a slot 846 a therethrough configured to receive acorresponding shaft 802 fixedly disposed within the handle assembly 12.As best illustrated in FIG. 123, the pawl 846 defines a generallytriangular configuration having a rocker surface 846 b at a first endand a tooth 846 c at a second end opposite the first end, configured toselectively engage the teeth 44 of the rack 40. The slot 846 a of thepawl 846 is oriented such that the slot 846 a extends in a directionfrom the rocker surface 846 b towards the tooth 846 c and is configuredto permit the pawl 846 to rotate about and slide along the shaft 802.

During normal operation, the pawl return spring 48 includes a springconstant capable of biasing the pawl 846 towards the rack 40. In thismanner, the pawl return spring 48 exerts a force upon the shaft 802 suchthat as the rack 40 begins to slide under the pawl 846 (FIG. 124), thepawl 846 deflects the pawl return spring 48 just enough to permit thepawl 846 to rotate, but does not allow the pawl 846 to translate on theshaft 802 and disengage the plurality of teeth 44 of the rack 40. Inother words, the pawl return spring 48 biases the pawl 846 in adirection such that the shaft 802 is disposed within the slot 846 aadjacent the rocker surface 846 b. Further, the force exerted by thepawl return spring 48 on the pawl 846 is great enough such that shouldthe trigger 18 be released by the clinician, the pawl 846 would restrainthe rack 40 against any proximal motion or allow the pawl 846 totranslate on the shaft 802, thereby inhibiting the rack 40 from slidingunderneath the pawl 846.

Should the clinician wish to abort firing the clip or otherwise wish toopen the jaws 16, the clinician may actuate the trigger 18 in anopposite direction (e.g., in a distal direction toward the initial, openposition). The force applied to the trigger 18 causes the teeth 44 ofthe rack 40 to exert a corresponding force against the tooth 846 c ofthe pawl 846, which is restraining proximal movement of the rack 40, andtherefore exerts a force against the pawl return spring 48. Additionalforce applied to the trigger 18 causes the pawl 846 to deflect the pawlreturn spring 48 and permit the pawl 846 to translate on the shaft 802(along the slot 846 a of the pawl 846) in a direction away from the rack40 (FIG. 125). In this manner, the tooth 846 c disengages from the teeth44 of the rack 40 and permits the rack 40 to slide underneath the pawl846 and return to the initial, unactuated position. Once the rack 40 hasreturned to the initial, unactuated position, the trigger 18 ispermitted to return to the initial or fully unactuated position and thejaws 16 are permitted to open.

As can be appreciated, the pawl return spring 48 may not providesufficient biasing force to enable the pawl 846 to operate normally(e.g., without sliding along the shaft 802 and allowing the tooth 846 cto disengage from the teeth 44 of the rack 40 unintentionally). Toinhibit the tooth 846 c from disengaging from the teeth 44 of the rack40 unintentionally, it is contemplated that a biasing element 848 (FIG.126) may be disposed within the slot 846 a of the pawl 846. In thismanner, the biasing element 848 is interposed between the shaft 802 anda portion of the slot 846 a opposite the tooth 846 c of the pawl 846such that the biasing element 848 provides additional biasing force tourge the pawl 846 towards the rack 40. It is contemplated that thebiasing element 848 may be retained within the slot 846 a of the pawl846 using any suitable means, such as a tab, adhesives, fasteners, orthe like. Although generally illustrated as being a coil spring, it iscontemplated that the biasing element 848 may be any suitable biasingelement capable of being compressed, such as a polymeric spring, gasspring, or the like. It is further contemplated that the biasing element848 may be any suitable extension spring, such as a coil spring or thelike.

With reference to FIGS. 127-130, an alternate embodiment of a ratchetassembly having an override feature or device capable of permitting theclinician to open the jaws 16 at any point during the firing of asurgical clip is illustrated and generally identified by referencenumeral 900.

The ratchet assembly 900, having an override feature, includes a pawl946 that is substantially similar to pawl 46, and therefore, forpurposes of brevity only the differences therebetween will be describedin detail hereinbelow. The pawl 946 defines a generally triangularconfiguration having a rocker surface 946 a at a first end and a tooth946 b at a second, opposite end that is configured to selectively engagethe teeth 44 of the rack 40. The pawl 946 is rotatably disposed about ashaft 902 that is translatably disposed within a corresponding slot 904defined within the handle assembly 12. As best illustrated in FIG. 128,the slot 904 is oriented perpendicular to the rack 40 and defines agenerally elongated “D” shaped configuration. In this manner, the slot904 defines an arcuate lower surface 904 a and a planar upper surface904 b, although other suitable configurations are also contemplated. Abiasing element 906 is disposed within the slot 904 and is interposedbetween the planar upper surface 904 b and the shaft 902 such that theshaft 902 is biased towards the arcuate lower surface 904 a of the slot904. Although illustrated as generally being a coil spring, it iscontemplated that the biasing element 906 may be any suitable biasingelement capable of being compressed, such as Bellville, leaf, polymericspring, gas spring, or the like. In one non-limiting embodiment, thebiasing element 906 may be any suitable extension spring.

The biasing element 906 includes a spring constant capable of biasingthe shaft 902, and thereby the pawl 946, towards the rack 40 duringnormal operation. In this manner, the biasing element 906 exerts a forceupon the shaft 902 such that as the rack 40 begins to slide under thepawl 946, the pawl 946 rotates to deflect the pawl return spring 48, butdoes not compress the biasing element 906 (FIG. 129). Further, the forceexerted by the biasing element 906 upon the shaft 902 is great enoughsuch that should the trigger 18 (FIG. 1) be released by the clinician,the pawl 946 would restrain the rack 40 against any proximal translationor allow the shaft 902 to translate within the slot 904 and permit therack 40 from sliding underneath the pawl 946. As can be appreciated, thepawl return spring 48 provides an additional biasing force againsttranslation of the shaft 902 within the slot 904. Accordingly, thespring rate of the biasing element 906, in combination with that of thepawl return spring 48, is such that the pawl 946 may rotate as describedin detail above, but not compress the biasing element 906 during normaloperation.

Should the clinician wish to abort firing the clip or otherwise wish toopen the jaws 16, the clinician may actuate the trigger 18 in anopposite direction (e.g., a distal direction toward the initial, openposition and away from the handle assembly 12). This opposite forceapplied to the trigger 18 causes the teeth 44 of the rack 40 to exert acorresponding force against the tooth 946 b of the pawl 946, which isrestraining movement of the rack 40, and therefore exerts a forceagainst the biasing element 906. Continued additional force applied tothe trigger 18 causes the biasing element 906 to compress therebypermitting the shaft 902, along with the pawl 946, to translate withinthe slot 904 towards the planar upper surface 904 b of the slot 904 andpermit the rack 40 to slide underneath the pawl 946 and return to theinitial, unactuated position (FIG. 130).

It should be understood that the foregoing description is onlyillustrative of the present disclosure. Various alternatives andmodifications can be devised by those skilled in the art withoutdeparting from the disclosure. Accordingly, the present disclosure isintended to embrace all such alternatives, modifications and variances.The embodiments described with reference to the attached drawing figuresare presented only to demonstrate certain examples of the disclosure.Other elements, steps, methods and techniques that are insubstantiallydifferent from those described above and/or in the appended claims arealso intended to be within the scope of the disclosure.

What is claimed is:
 1. An apparatus for applying surgical clips to bodytissue, comprising: a handle portion; and a trigger rotatably coupled tothe handle portion, the handle portion including: a rack slidablysupported within the handle portion and in mechanical communication withthe trigger, the rack configured to translate from a first, proximalposition, to a second, distal position; a pawl slidably and rotatablysupported within the handle portion, the pawl being in selectiveengagement with the rack; and a biasing element supported by the handleportion and in mechanical communication with the pawl, the biasingelement having a biasing force configured to bias the pawl towards therack such that the rack is permitted to translate in a distal direction,but is selectively inhibited from translating in a proximal directionuntil the rack is in the second, distal position, wherein actuation ofthe trigger in a proximal direction causes the rack to translate in adistal direction and actuation of the trigger in a distal directionurges the rack in a proximal direction and causes the pawl to exert aforce on the biasing element, wherein when the force exerted on thebiasing element is greater than the biasing force, the biasing elementdeflects allowing the pawl to disengage from the rack and permit therack to translate in a proximal direction to the first, proximalposition.
 2. The apparatus of claim 1, wherein the rack defines aplurality of ratchet teeth on a surface thereof.
 3. The apparatus ofclaim 2, wherein the pawl defines a tooth configured to selectivelyengage the plurality of ratchet teeth.
 4. The apparatus of claim 3,wherein the pawl defines a slot therethrough extending in a directionfrom the tooth towards a surface defined opposite the tooth.
 5. Theapparatus of claim 4, wherein the biasing element biases the pawl towardthe rack such that the tooth of the pawl engages the plurality ofratchet teeth of the ratchet to selectively inhibit proximal translationof the rack.
 6. The apparatus of claim 5, wherein the pawl is slidablyand rotatably supposed on a shaft disposed on the handle portion.
 7. Theapparatus of claim 6, further including a second biasing element that isdisposed within the slot of the pawl and that is interposed between theshaft of the handle portion and a portion of the slot of the pawl, thesecond biasing element configured to exert additional biasing force onthe pawl towards the rack.
 8. The apparatus of claim 3, wherein thehandle portion defines a slot therein, the slot configured to slidablyreceive a shaft therein, wherein the pawl is rotatably supported on theshaft.
 9. The apparatus of claim 8, further including a second biasingelement that is disposed within the slot of the handle portion, thesecond biasing element interposed between the shaft and a portion of theslot to exert an additional biasing force on the shaft towards the racksuch that the tooth of the pawl selectively engages the plurality ofratchet teeth of the ratchet to selectively inhibit proximal translationof the rack.
 10. The apparatus of claim 9, wherein actuation of thetrigger in a distal direction urges the rack in a proximal direction andcauses the pawl to exert a force that is greater than the biasing forcesof the first and second biasing elements and causes the pawl totranslate in a direction away from the rack, wherein continued actuationof the trigger in the distal direction causes the pawl to change itsengagement with the rack and permits the rack to translate in a proximaldirection to the first, proximal position.
 11. A ratchet assembly foruse with an apparatus for applying surgical clips to body tissue,comprising: a pawl slidably supported within a handle portion of theapparatus for applying surgical clips to body tissue; and a biasingelement supported by the handle portion of the apparatus and inmechanical communication with the pawl, the biasing element having abiasing force configured to bias the pawl towards the rack such that therack is permitted to translate in a distal direction, but is selectivelyinhibited from translating in a proximal direction until the rack is ina distal-most position, wherein when the rack is urged in a proximaldirection, the pawl exerts a force on the biasing element, wherein whenthe force exerted on the biasing element is greater than the biasingforce, the biasing element deflects allowing the pawl to disengage fromthe rack and permit the rack to translate in a proximal direction. 12.The ratchet assembly of claim 11, wherein the rack defines a pluralityof ratchet teeth on a surface thereof.
 13. The ratchet assembly of claim12, wherein the pawl defines a tooth configured to selectively engagethe plurality of ratchet teeth.
 14. The ratchet assembly of claim 13,wherein the pawl defines a slot therethrough extending in a directionfrom the tooth towards a surface defined opposite the tooth.
 15. Theratchet assembly of claim 14, wherein the biasing element biases thetooth of the pawl into engagement with the plurality of ratchet teeth ofthe ratchet to selectively inhibit proximal translation of the rack. 16.The ratchet assembly of claim 15, wherein the pawl is slidably androtatably supposed on a shaft disposed on the handle portion of theapparatus for applying surgical clips to body tissue.
 17. The ratchetassembly of claim 16, further including a second biasing element that isdisposed within the slot of the pawl and that is interposed between theshaft of the handle portion of the apparatus for applying surgical clipsto body tissue and a portion of the slot of the pawl, the second biasingelement configured to exert additional biasing force on the pawl towardsthe rack.
 18. The ratchet assembly of claim 13, wherein the pawl isrotatably supported on a shaft, the shaft slidably received within aslot defined in the handle portion of the apparatus for applyingsurgical clips to body tissue.
 19. The ratchet assembly of claim 18,further including a second biasing element that is disposed within theslot of the handle portion of the apparatus for applying surgical clipsto body tissue, the second biasing element interposed between the shaftand a portion of the slot to exert additional biasing force on the shafttowards the rack such that the tooth of the pawl selectively engages theplurality of ratchet teeth of the ratchet to selectively inhibitproximal translation of the rack.
 20. The ratchet assembly of claim 19,wherein when the rack is urged in a proximal direction, the rack causesthe pawl to exert a force that is greater than the biasing forces of thefirst and second biasing elements and causes the pawl to translate in adirection away from the rack, wherein further urging of the rack in aproximal direction causes the pawl to change its engagement with therack and permits the rack to translate in a proximal direction.